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Brain Tumor Surgery

A tumor is an abnormal growth in the brain which may be sometimes cancerous. Non-cancerous or benign tumors can be treated by surgery alone. However, malignant or cancerous tumors may require other treatments like chemotherapy and radiotherapy along with surgery.

The goals of surgical approach for the removal of brain tumors are many and may include one or more of the following:

  • Confirm cancer diagnosis by obtaining tissue for a biopsy.
  • Remove a tumor completely or as much as possible.
  • Eliminate symptoms and improve quality of life by relieving intracranial pressure caused by the tumor.
  • Provide access for implantation of internal radiation or chemotherapy source.
  • Provide access for delivering intra-surgical treatments, like laser surgery.

Each patient’s unique circumstances will determine which approach is chosen for his/her surgical treatment. The main approaches are:

  • Craniotomy- It is a procedure in which a section of skull bone is temporarily removed to allow the brain tumor surgeon or neurosurgeon access to the brain and the tumor. Traditionally an open surgery technique, craniotomy can now be performed using minimally invasive techniques using a smaller opening in the skull. The recovery time is faster in this case.
  • Transsphenoidal surgery- It is a minimally invasive procedure done either through the inside of the mouth or through the nostrils with the aid of an endoscope. The procedure requires very small incisions which are often not visible.

Brain tumor surgery is usually suggested after a brain tumor is found on a diagnostic imaging scan. Surgeons remove as much of the tumor as possible while preserving brain functionality and nearby tissues. Gliomas, meningiomas, acoustic neuromas, pituitary tumors, primitive neuroectodermal tumors, medulloblastomas, craniopharyngioma, pineal region tumors, clival tumors, and esthesioneuroblastomas are some of the surgically treated tumor types.

In addition to the neurosurgeon, a team of doctors are involved in treating a brain tumor. They are:

  • Otolaryngologist
  • Head and neck surgeon
  • Ophthalmologist
  • Oral and maxillofacial surgeon
  • Plastic surgeon

Surgical techniques

Different surgical techniques are employed in the treatment of brain tumors. The technique used for a particular patient usually depends on the tumor type and its location. Few of the commonly used techniques are:

  • Stereotactic surgery- A 3D image of the brain is created in order to obtain precise location and other details of the tumor, making it particularly useful for reaching a tumor located deep within the brain, such as the thalamus or stem of the brain.
  • Embolization-  Conducted prior to surgery, embolization is used to reduce the amount of blood supply to a tumor by blocking the flow of blood in selected arteries.
  • Endoscopy- Endoscopes are long, narrow, flexible lighted tubes that are inserted into the surgical area facilitating minimally invasive surgical procedures. An endoscope provides the surgeon with light and visual access without having to make large incisions.
  • Laser surgery- Laser surgery involves the use of laser beams which are directed at the tumor. The cancer cells are then destroyed due to the heat.
  • Photodynamic laser surgery-  Photodynamic therapy involves the use of a drug that increases a tissue’s sensitivity to laser surgery. The photosensitizing drug is injected into a vein or artery before the surgery. As a result, the treated tumor cells appear fluorescent during surgery. The brain tumor surgeon then activates the drug using laser and the cancer cells are destroyed.
  • Ultrasonic aspiration- This technique utilizes ultrasonic waves to break the tumor into small pieces, which are then aspirated, or sucked out.

 

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