Alfredo Quinones-Hinojosa, M.D., a neurosurgeon at Mayo Clinic's campus in Jacksonville, Florida, shares information about an innovative technique that offers patients with brain tumors a scarless treatment option.
Leveraging the expertise of surgeons who are familiar with the anatomy of the brain, eyes and frontal sinuses, this minimally invasive technique builds on an upper blepharoplasty — the cosmetic surgery for aging eyelids. Surgeons access the supraorbital bone through the fold within the upper eyelid. Then, through the quarter-sized incision, tiny cameras and microsurgical tools are introduced into the brain to remove the tumor.
At the end of surgery, a plastic and reconstructive surgeon closes the incision, ensuring the tiny scar remains well-hidden.
ALFREDO QUINONES-HINOJOSA: Well, we use what we call scarless brain surgery. We don't leave a scar on the patients when we go nowadays and try to take out some of the most complex brain tumors that affect the human body and the human brain. We pioneered this technique to be able to go through the eyelid to resect brain tumors. This innovative technique utilizes the expertise of several teams. In one side, you have the plastic surgeons-- being able to use a similar technique that they have used for many years for cosmetic surgery for the eyelid. This allows then to do a small opening in the bone that then allows us to get right under the brain, go in, and take out these tumors with minimal to no collateral damage to the brain. This surgery is extraordinarily complex once you get down into the brain. You have to consider that you're trying to disconnect these tumors from blood vessels from nerves from bone from dura and the corridor is extraordinarily narrow. When you are about 6 centimeters deep into the brain through a small little hole the size of a quarter, it makes the surgical approach extraordinarily complex. Traditionally, these tumors used to be removed through a large incision behind the hairline, removing the face and the forehead skin forward to be able to do an opening in the bone right above the eye. I would say that there are very few centers around the world that use this very specific technique of going through the eyelid. This technique of the supraorbital eyelid technique is not very common. The reason is because it really does require a tremendous expertise not only from the plastic surgeon to be able to do the incision and the reconstruction, but also from the brain surgeon to be able to work through small corridors where the instruments barely fit. This is amazing. I would say that the way the patients benefit from this type of surgical approach is first and foremost, they come in and they go home in one or two days. Sometimes they only stay in the hospital overnight for brain surgery. Number two, they go home and their scars heal beautifully. In a couple of weeks, you can barely tell that they had surgery. Number three, they go back to work much sooner. And number four, their quality of life and the way they feel about themselves is extraordinarily much more positive than when we used to do some of these very large surgical approaches.