Surgeons can now safely and effectively operate inside the human brain through a small incision in the natural creases of an eyelid.
Writing in a pair of studies, one published in the June issue of the Journal of Otolaryngology – Head and Neck Surgery and another set to appear in the July issue of Skull Base, the Johns Hopkins team describes what are believed to be the first published cases studies of the procedure, documenting how it was used to repair brain fluid leaks, conduct tissue biopsy and remove tumors.
All are common surgeries, but were performed in patients whose complex illnesses made the traditional approach too risky or untenable.
The minicraniotomy through the eyelid requires surgeons to remove only a small, half-inch to one-inch-square section of skull bone right above the eyebrow, which is later replaced, to gain access to the body’s nervous system control center.
Once access to the brain is secured, a microscope- and computer-guided endoscope, fitted with a camera, are used to precisely thread other surgical instruments into the soft tissue to perform the operation, using high-tech maps created by advanced CT and MRI scans of the brain.
Boahene says the new approach takes on average less than two hours in the operating room, as opposed to the traditional four to eight hours; poses less risk of infection; and requires usually an overnight stay instead of four days or longer in the hospital.
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