Novel brain surgery technique targets difficult tumours at skull base

New Delhi : Japanese researchers have pioneered a new technique for brain surgery that targets difficult tumours at the skull base -- an area densely packed with nerves, blood vessels, other tissues, and the brain stem.

Tumours occurring in the base of the skull are among the most difficult to remove in neurosurgery. The current treatment method is to perform surgical removal by what is known as the microscopic anterior transpetrosal approach (ATPA).

A medical research team at the Osaka Metropolitan University developed a new minimally invasive surgical technique called a purely endoscopic subtemporal keyhole ATPA. The approach seeks to lessen the risk of damage and postoperative complications.

The endoscopic technique means a smaller area of the skull needs to be surgically opened compared to the microscopic approach, an average of only 11.2 cm2 versus 33.9 cm2. The risk of damage to the brain is also reduced, the team members wrote in The Journal of Neurosurgery.

Between 2022 and 2023, the team performed 10 neurosurgeries using their method at Osaka Metropolitan University Hospital and compared the results to 13 surgeries using the microscopic ATPA from 2014 to 2021.

The endoscopic approach noticeably reduced operative time, from an average of 410.9 minutes to 252.9 minutes. Similarly, blood loss lessened from a mean of 193 ml to 90 ml.

The degree of tumour resection (surgical removal) was just as high as the microscopic method, while neurological functions were preserved at a rate equal to or higher than with the conventional approach.

"Comparison of the new endoscopic method and the conventional microscopic method showed no significant difference in tumour resection rate or in the ability to perform daily activities before and after surgery, with the new endoscopic approach resulting in shorter operative times and less blood loss," said Professor Takeo Goto, head of Department of Neurosurgery at the varsity.

"The widespread use of this surgical procedure is expected to improve the treatment results of brain tumours in the base of the skull, not only in Japan but also worldwide," he added.