Retired company director Ron Jones
has undergone a remarkable new form of surgery that allows brain tumors
to be removed through the nose.
Traditionally, such operations involved surgeons opening the skull – a procedure known as a craniotomy – and delving downwards.
Alternatively, parts of the brain were reached via large incisions in the side of the face or inside the mouth, all options that leave major scars.
But pioneering brain surgeons at
Sheffield’s Hallamshire Hospital have adopted a US-developed technique
to reach deep-set tumors using an endoscope that is fed through the
nose.
Ron, 83, a former grain salesman who lives in Market Rasen, Lincolnshire, with his wife Sylvia, a former teacher, was diagnosed with a tumor on his pituitary gland, which sits at the base of the skull, in October last year.
These growths are ideally suited for nasal endoscopy because the gland is close to the back of the nasal cavity and relatively easy to reach. Ron’s tumor was the size of a small egg.
Cutting instruments, also mounted on flexible or telescopic arms, are used to remove the growth in pieces. The new procedure reduces the operating time by up to two hours,
reduces the risk of infection, and allows for a quicker recovery compared to the older techniques.
Neurosurgeon Saurabh Sinha, who operated on Ron, says: ‘The endoscope provides a close-up view of the pituitary which means we can get all of the tumor out in one go.
‘Because of Ron’s age, he might not have been considered for open brain surgery, as older patients don’t always recover from such a major procedure. And patients who have weaker hearts will benefit from this innovation. The beauty of the procedure is that there is less danger of brain damage or stroke, and the patient makes a quicker recovery.
Before, they may have been in hospital for a week. Now I can discharge some patients within three days.’
‘I first noticed something last year,’ says Ron. ‘I saw a tide mark in my vision. Later, I started having blinding headaches and seeing double.’
Scans showed Ron had a growth on his pituitary gland. About 2,000 people a year require surgery to remove tumors on the pituitary.
Oval in shape, the gland measures an inch in length and it secretes eight hormones that control vital functions, such as body growth, general health and energy levels. In men it is responsible for producing the sex hormone testosterone. Ten to 20 per cent of people have a benign pituitary tumor, but only a small proportion of these cause symptoms, with a tiny fraction needing surgery. Most people are likely to live a normal life without knowing they have a tumor. But Ron’s growth was so large it was pressing on the nerves around the eyes, affecting his vision.
‘I was also suffering pain in my joints, and having trouble going to the loo which doctors explained wasn’t just my age, but because the tumor was stopping my body from releasing the right hormones,’ says Ron. When he came round from the surgery there wasn’t a single external mark.
‘When I was told I had a tumour in my head I had visions of my skull being sliced open to remove it,’ he says. ‘Now my sight is back to normal and I have been in no pain at all. I was walking around straight away, and back to playing golf in two months. My memory isn’t what it was, and I have to write things down or I forget them, but I suppose that could just be my age. Physically, though, I feel better than ever.’
Traditionally, such operations involved surgeons opening the skull – a procedure known as a craniotomy – and delving downwards.
Alternatively, parts of the brain were reached via large incisions in the side of the face or inside the mouth, all options that leave major scars.
Revolutionary: Traditionally, such operations involved surgeons opening the skull
Ron, 83, a former grain salesman who lives in Market Rasen, Lincolnshire, with his wife Sylvia, a former teacher, was diagnosed with a tumor on his pituitary gland, which sits at the base of the skull, in October last year.
These growths are ideally suited for nasal endoscopy because the gland is close to the back of the nasal cavity and relatively easy to reach. Ron’s tumor was the size of a small egg.
- Surgeons now hope the success of this operation will pave the way for other types of brain tumor to be removed without making a single incision.
Pioneering: The tumor is reached by working
through one nostril and making a hole in the back of the nasal cavity
into the bottom of the skull
reduces the risk of infection, and allows for a quicker recovery compared to the older techniques.
Neurosurgeon Saurabh Sinha, who operated on Ron, says: ‘The endoscope provides a close-up view of the pituitary which means we can get all of the tumor out in one go.
‘Because of Ron’s age, he might not have been considered for open brain surgery, as older patients don’t always recover from such a major procedure. And patients who have weaker hearts will benefit from this innovation. The beauty of the procedure is that there is less danger of brain damage or stroke, and the patient makes a quicker recovery.
Before, they may have been in hospital for a week. Now I can discharge some patients within three days.’
‘I first noticed something last year,’ says Ron. ‘I saw a tide mark in my vision. Later, I started having blinding headaches and seeing double.’
Scans showed Ron had a growth on his pituitary gland. About 2,000 people a year require surgery to remove tumors on the pituitary.
Oval in shape, the gland measures an inch in length and it secretes eight hormones that control vital functions, such as body growth, general health and energy levels. In men it is responsible for producing the sex hormone testosterone. Ten to 20 per cent of people have a benign pituitary tumor, but only a small proportion of these cause symptoms, with a tiny fraction needing surgery. Most people are likely to live a normal life without knowing they have a tumor. But Ron’s growth was so large it was pressing on the nerves around the eyes, affecting his vision.
‘I was also suffering pain in my joints, and having trouble going to the loo which doctors explained wasn’t just my age, but because the tumor was stopping my body from releasing the right hormones,’ says Ron. When he came round from the surgery there wasn’t a single external mark.
‘When I was told I had a tumour in my head I had visions of my skull being sliced open to remove it,’ he says. ‘Now my sight is back to normal and I have been in no pain at all. I was walking around straight away, and back to playing golf in two months. My memory isn’t what it was, and I have to write things down or I forget them, but I suppose that could just be my age. Physically, though, I feel better than ever.’
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