First endoscopic surgery on the brow to remove a tumor in the anterior skull base

NDO - Viet Duc Friendship Hospital has successfully performed endoscopic surgery through a small incision above the eyebrow to remove tumors in the anterior skull base for 2 patients.

Associate Professor, Doctor Dong Van He, Deputy Director of Viet Duc Friendship Hospital, President of the Vietnam and ASEAN Neurosurgery Association, said that this technique belongs to a state-level research project on minimally invasive neurosurgery, approved by the Ministry of Science and Technology, with the goal of improving treatment methods, minimizing invasion and risks for patients. This is also the first technique to be successfully performed in Vietnam.

Endoscopic surgery in the field of neurology and cranial nerves developed later than other specialties such as thoracic, abdominal, knee or joint endoscopy. In Vietnam, neuroendoscopy started in 2003 with simple interventions such as hydrocephalus treatment, then gradually expanded to more complex techniques, especially endoscopic surgery of the skull base through the nose.

This is one of the important directions in state-level research of Associate Professor, Dr. Dong Van He, focusing on the application of endoscopy in the treatment of neurological diseases.

Dr. He said that in the past, to intervene in lesions of the skull base, doctors often had to expand the skull and use a microscope. Some cases of lesions of the middle layer could be accessed by endoscopy through the nose, but this method was not feasible for tumors in difficult-to-reach locations.

Now, with the new method, the doctor only needs to make a small incision in the eyebrow arch, insert an endoscope to support the light source, observe the lesion and perform surgery to accurately remove the tumor.

Last week, Viet Duc Hospital successfully performed two surgeries to remove meningiomas in the anterior skull base using this technique. Both patients had tumors located right above the roof of the eye socket. One patient had a tumor measuring 1.8cm in diameter and the other had a tumor of nearly 3cm. Both surgeries were successful, and the patients recovered well.

Previously, if using the classic approach, the doctor had to open the skull widely or use a microscope for surgery. But with the new method, the entire process is performed endoscopically, helping to effectively remove the tumor while still preserving the surrounding structures as much as possible.

According to Associate Professor Dong Van He, since 2005, Viet Duc Friendship Hospital has applied this technique but used a microscope. Only recently have doctors experimented with combining endoscopy in some stages. This time, the entire surgical process was performed by endoscopy.

This technique has many outstanding advantages such as the endoscope directly accessing the lesion with flexible viewing angles (0 degrees, 30 degrees, 45 degrees), helping the surgeon clearly observe the entire lesion area without much impact on the brain parenchyma.

Preoperative (right) and postoperative (left) MRI scans of the patient.

This method minimizes the risk of complications and damage to important nerves such as the optic nerve and olfactory nerve. Doctors performing the technique do not need to expand the brain tissue, reducing the rate of damage to healthy tissue.

The endoscopic light system gives the surgeon better visibility than with a traditional microscope, allowing for precise assessment of the boundary between tumor and healthy tissue.

With this method, recovery time is faster, patients can be discharged early and return to normal life in a short time.

With the initial success of this technique, this will be a new direction in minimally invasive neurosurgery, opening up more opportunities for safer and more effective treatment for patients in Vietnam.

Source: https://nhandan.vn/lan-dau-tien-phau-thuat-noi-soi-tren-cung-may-cat-bo-khoi-uo-tang-truoc-nen-so-post862990.html