Featured Research

from universities, journals, and other organizations

Researchers quantify benefits of minimally invasive removal of hard-to-reach tumors

Date:
May 10, 2010
Source:
University of Cincinnati Academic Health Center
Summary:
A minimally invasive endoscopic procedure holds promise for safely removing large brain tumors from an area at the bottom of the skull, near the sinus cavities, clinical researchers have found.

Philip Theodosopoulos, MD.
Credit: Image courtesy of University of Cincinnati Academic Health Center

A minimally invasive endoscopic procedure holds promise for safely removing large brain tumors from an area at the bottom of the skull, near the sinus cavities, clinical researchers at the Brain Tumor Center at the University of Cincinnati Neuroscience Institute (UCNI) at University Hospital have found.

Related Articles


The findings, to be published in the April 2010 issue of the Journal of Neurosurgery and previously published online in October 2009, have important implications for patients with large pituitary tumors (pituitary macroadenomas).

"This is the first time that a quantitative advantage has been shown for the use of endoscopy in cranial surgery," says Philip Theodosopoulos, MD, principal investigator of the study, director of skull base surgery at UC and a neurosurgeon with the Mayfield Clinic.

"This signals the dawn of a new era in minimally invasive cranial surgery. We have moved from the realm of assessing whether it is feasible to studying its clinical effectiveness. In this way, it is slowly starting to change from a novelty to standard treatment, setting the bar for the quality of surgical outcomes higher than ever before."

Although tumors of the pituitary gland, located near the base of the skull, are benign, pituitary macroadenomas can wreak havoc, causing acromegaly (an overproduction of growth hormone), Cushing disease (an overproduction of the hormone cortisol) and hyperthyroidism, as well as visual problems, headaches and dizziness.

When removing pituitary macroadenomas (tumors that are larger than 10 millimeters), surgeons have employed three distinct routes to the tumor:

• Through the skull, in a procedure called a craniotomy. • Through an incision under the upper lip and then through the septum, which must be split apart. • Through the nostrils -- a transnasal approach -- without an incision.

The endoscopic transsphenoidal approach, Theodosopoulos says, follows natural anatomical corridors and causes less disruption of nasal tissues. This approach, as the new study reveals, also holds benefits related to complete tumor removal, which is important for the patient's quality of life.

Removing an entire pituitary macroadenoma can be difficult because the tumor's growth pattern can cause it to extend through the sinus corridor, which is out of the surgeon's view.

Surgeons can ensure that the entire tumor has been removed if their hospital operating room is equipped with a technology known as intraoperative MRI, or ioMRI. The surgery-prolonging technology enables surgeons to take MRI scans while the patient is still under anesthesia and on the operating table. The UC Neuroscience Institute at University Hospital has had ioMRI since 1999, but the expensive technology is not available at most hospitals.

An endoscopic approach, by contrast, allows the surgeon to check for remaining tumor with "intrasellar endoscopy." Using a tiny, sophisticated camera on an angled endoscope, the surgeon can peer around bends and into crevasses to identify any remaining tumor. "The endoscopic approach holds the potential for less invasive treatment for all patients and more complete tumor resections for individuals treated in hospitals without access to intraoperative MRI," Theodosopoulos says.

During the retrospective study at University Hospital, the team analyzed surgical outcomes of 27 consecutive patients between 2005 and 2007 who had undergone endoscopic removal of pituitary macroadenomas. The search for unexpected residual tumor was conducted two ways in all patients: first with the tiny endoscopic camera (intrasellar endoscopy) and then with intraoperative MRI.

Following the initial endoscopic tumor removal, intrasellar endoscopy revealed that 23 of the 27 patients (85 percent) had no unexpected residual tumor. Surgeons were able to safely perform additional surgery on three of the four patients who had unacceptable residual tumor.

Following the endoscopic procedures, all patients were checked with intraoperative MRI, which revealed that tumor removal was successful in 26 patients (96 percent).

The study results show that maximum tumor removal can be successfully achieved with endoscopy and without intraoperative MRI, Theodosopoulos says. He adds, however, that the findings could be strengthened by a larger study.

Additional study participants included John Tew, MD (Mayfield Clinic, UC Department of Neurosurgery and UCNI), Lee Zimmer, MD (UC Department of Otolaryngology and UCNI), James Leach, MD (Cincinnati Children's Hospital Medical Center and UCNI), Bharat Guthikonda, MD (UC Department of Neurosurgery) and Amanda Denny, MD (UC Department of Endocrinology). Also participating was Sebastien Froelich, MD (Department of Neurosurgery, University of Strasbourg, France).


Story Source:

The above story is based on materials provided by University of Cincinnati Academic Health Center. Note: Materials may be edited for content and length.


Cite This Page:

University of Cincinnati Academic Health Center. "Researchers quantify benefits of minimally invasive removal of hard-to-reach tumors." ScienceDaily. ScienceDaily, 10 May 2010. <www.sciencedaily.com/releases/2010/04/100401130236.htm>.
University of Cincinnati Academic Health Center. (2010, May 10). Researchers quantify benefits of minimally invasive removal of hard-to-reach tumors. ScienceDaily. Retrieved October 25, 2014 from www.sciencedaily.com/releases/2010/04/100401130236.htm
University of Cincinnati Academic Health Center. "Researchers quantify benefits of minimally invasive removal of hard-to-reach tumors." ScienceDaily. www.sciencedaily.com/releases/2010/04/100401130236.htm (accessed October 25, 2014).

Share This



More Health & Medicine News

Saturday, October 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com
WHO: Millions of Ebola Vaccine Doses by 2015

WHO: Millions of Ebola Vaccine Doses by 2015

AP (Oct. 24, 2014) The World Health Organization said on Friday that millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines would start being tested in March. (Oct. 24) Video provided by AP
Powered by NewsLook.com
Doctor in NYC Quarantined With Ebola

Doctor in NYC Quarantined With Ebola

AP (Oct. 24, 2014) An emergency room doctor who recently returned to the city after treating Ebola patients in West Africa has tested positive for the virus. He's quarantined in a hospital. (Oct. 24) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins