Published on Mar 6, 2012
"A lot of people when I tell them I've had cancer, they look at me and it's like, We can't tell."
This patient suffered for years with ear aches, which were caused by a large skull-based tumor. A team of doctors at the Cranial Base Center at the Ohio State University Comprehensive Cancer Center ñ Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, have pioneered an innovative surgical approach to treating these types of cancers. Their technique combines endoscopic endonasal surgery with the use of minimally invasive robotic surgery. When combined, these techniques allow doctors to reach the entire tumor while sparing patients from having surgical incisions in their faces and soft palates, and allowing for a quicker recovery.
Dr. Ricardo Carrau:
"These are two techniques that are basically complementary.
"So if you use them together, you can get access to the entire tumor. To our knowledge, this is the first time the two techniques are used in patients.
The tumor had grown below the hard palate, and this type of malignant cancer can spread to distant sites, including the lungs and bones, said Carrau. This type of tumor is called adenoid cystic carcinoma, and it comes from the glands and often follows nerves.
Dr. Daniel Prevedello:
"In his case, it was a tumor that was invading the side of his skull going in the direction of the Eustachian tube, which is the structure that prevents problems in the middle ear.
In the past, to surgically remove this type of tumor the surgeon would have to split open the soft palate. In this case, two minimally invasive techniques were used to access areas where each could not reach on its own by going through the nose or the mouth. Surgeons at Ohio State have successfully completed this technique on two patients, including one who had suffered for more than a year with severe headaches, vision problems and fatigue caused by a malignant skull-based tumor called a chordoma. Before her surgeries, Dr. Prevedello explained the procedure to patient Margaret Handshoe..
"He just said that it was on the brain stem and that is was where all my nerves come together. He was saying that they had a new technique doing it with robotics.
Dr. Daniel Prevedello:
"The traditional approach for this type of lesions of the skull base requires incisions in the face, on the side of the nose, and the roof of the mouth, which is called the palate. And those cuts can cause problems for the patients. When we do the minimally invasive techniques, we avoid those cuts, and the patients tend to heal faster and with less problems.î
"I think it's just amazing they can go through your nose and your mouth and remove a tumor like that, you know, and you don't have no scars.
Dr. Enver Ozer:
"When approaching from the oral cavity, you just use a natural orifice as a passage to reach those tumors and then you avoid the external incisions in the face and disfigurement of the face.
The use of minimally invasive robotic-assisted surgery offers a number of advantages, including three-dimensional visualization, tremor-free surgical tools and magnified vision. Both patients are doing well.
"The nature of these techniques is such that they are advancing very quickly.
"This type of surgery offers improved quality of life and functional benefits for the patients.