Hrayr Shahinian Explains Head & Neck Tumors and Minimally Invasive Microsurgery of the Skull Base

Nov. 5, 2010 - PRLog -- Hrayr Shahinian - Surgical resection of head and neck tumors extending to or through the skull base requires special expertise combining the talents of skull base surgeons and head and neck surgeons; the multidisciplinary team may also include neuroradiologists and radiation and medical oncologists.

Newer approaches including endoscopic techniques to access these tumors have made a dramatic impact on the overall outcomes by reducing mortality and morbidity, reducing hospital stay and improving overall prognosis. Many head and neck cancers that were previously thought to be inoperable have been successfully removed through small and precise exposures by these techniques.

One of the challenges is to resect the tumor without any disfiguring scars. This can be done by hiding all the scars either in the hairline, the conjunctiva (inside the eyelid) or inside the mouth. The advent of minimally invasive endoscopic techniques has facilitated the resection of these tumors completely through such "hidden" or natural openings such as the nostril, the hair of the eyebrow or the inside of the eyelid.

At the Skull Base Institute we have combined traditional techniques such as the infratemporal fossa approach with minimally invasive endoscopic approaches in order to resect completely massive tumors of the skull base with minimum discomfort and complications and maximum safety and preservation of vital neurologic and cranial nerve functions.

Many of these patients require neuroradiologic embolisation of their tumors 48 hours prior to surgery and in many occasions they also require a carotid balloon test occlusion. These neuroradiologic tests allow us to perform the surgery safely, minimizing the amount of bleeding from the tumor and also allowing us to know in advance whether any blood vessels including either carotid or any of their branches can be safely occluded without the patient suffering any adverse effects. To date we have collaborated with our colleagues in interventional neuroradiology on hundreds of such patients who have had their tumors successfully embolised preoperatively followed by a surgical resection 48 hours later.

Some of these patients have also required adjuvant radiation therapy and chemotherapy either systemically or intraarterially. For those patients we have combined our efforts with colleagues in the fields of radiation oncology and medical oncology in order to provide our patients with the most up to date multidisciplinary therapies available.

For more information please visit http://www.hrayrshahinianblog.org or skullbaseinstitute.com

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Hrayr Shahinian, M.D. is regarded as a pioneer in the field of medicine for his revolutionary use of minimally invasive endoscopy in performing skull base surgery.