The Department of Surgery at the American University of Beirut Medical Center (AUBMC) performed the first Endoscopic Endonasal resection of large olfactory groove meningioma in Lebanon. The first- of-its-kind procedure permits the surgeon to remove tumors in the brain with less traction on it and better tumor control, providing a more advanced technique that allows patients a better quality of life.
The surgery was performed by Dr. Houssein Darwish, Brain and Spine Surgeon, Division of Neurosurgery, Department of Surgery at AUBMC assisted by Ear, Nose, and Throat (ENT) surgeon, Dr. Zeina Korban. These kinds of tumors, skull base tumors, were previously performed through a major craniotomy (open brain surgery). By applying this novel approach for the first time in Lebanon, the team resected the large olfactory groove meningioma without resorting to opening the patient’s skull and brain; instead, they used an endoscope and accessed the tumor only through the nose.
“The endoscopic endonasal trans-cribriform approach offers the most direct and immediate exposure to the tumor without brain retraction and manipulation of neurovascular structures. This is an additional technique for skull base surgery that helps in removing tumors with less traction on the brain and better tumor control,” said Dr. Houssein Darwish. “AUBMC is providing the endoscopic skill base service with high standards for the benefit of our patients, thus remaining abreast with the World’s best centers,” added Dr. Darwish.
“The surgery is a major advancement in skull base tumor resection at AUBMC, as now we can access difficult-to-reach areas and treat them without performing a major open brain surgery,” said Dr. Zeina Korban. “This technique provides us with the ability to tackle brain and neural tissue tumors without touching the brain till the end of the resection. Skull base and endoscopy services make long and hard cases easier on patients,” she added.
Endoscopic endo-nasal skull base surgery is a minimally invasive approach that uses the nose and sinuses as natural corridors to access tumors and lesions in critical areas at the base of the skull or top of the spine. It allows surgeons to treat many hard-to-reach tumors, even those that were once considered “inoperable”. This gives the surgeon access to parts of the patient’s brain that would be hard to reach using traditional surgical approaches and often require large incisions and removal of parts of the skull. The endoscope has been previously used to resect pituitary tumors, whereas through this approach, the boundaries of tumor resection are extended without opening the brain and the skull, and in the resection of superior orbital fissure and optic canal tumor, which ultimately leads to faster recovery and less morbidity.