Reported August 2005

BACKGROUND: The brain has critical tissues at its base and at the top of the spinal cord. Surgery to those areas to remove brain tumors used be very invasive. Now a new approach, called endoscopic transnasal brain surgery (ETBS), allows surgeons to operate safely on large tumors and problematic blood vessels near those important areas. ETBS also offers hope of successful treatment and recovery to those with deep-seated brain tumors that were previously considered inoperable.

HOW IT WORKS: ETBS uses miniature instruments and cameras at the end of long tubes. Surgeons thread these narrow scopes and tools into the soft tissue of the nasal cavity, enabling them to access tumors in previously hard-to-reach areas of the brain.

BENEFITS: The more traditional surgical technique for accessing brain tumors is called a craniotomy. It involved peeling away skin from the face and cutting the skull open. There was a high risk of infection, substantial blood loss and considerable facial scarring from this method, among other complications. ETBS is much less invasive and causes far fewer lingering side effects than traditional skull base surgery. Although the procedure is not without its own risks, patients are usually discharged within several days and incur no scarring from incisions.

WHERE TO FIND IT: The University of Pittsburgh Medical Center will open a 3000 square foot operating room at its Minimally Invasive Neurosurgical Center, specifically for the ETBS procedure, in July.

WHAT CAUSES BRAIN TUMORS: Brain tumors, like most other cancerous growths, are the result of uncontrolled cell divisions caused by mutations in key genes within those cells -- in this case, the neurons in the brain. Normal neurons don't divide because their genetic coding tells them not to do so. Cancerous neurons are mutated so that the growth switch is turned back on. They begin to divide and multiple uncontrollably, forming a tumor.

ON THE WEB: About ETBS: http://transnasalbrainsurgery.upmc.com

If you would like more information, please contact:

Department of Neurological Surgery
UPMC Presbyterian, Suite B-400
200 Lothrop Street
Pittsburgh, PA 15213
(412) 647-3685
(412) 647-0989

neuroinfo@upmc.edu

Did you know...

ETBS is not a hew procedure; it is one of the earliest neurosurgical procedures performed, developed almost 100 years ago by the "father of neurosurgery," Harvey Cushing.

The first brain tumor was excavated through the nose using a primitive endoscope in 1909, although the surgery was not successful.