New research determines that physicians don't have to saw off the top of the skull to conduct many kinds of brain surgery — rather, they can just go in through the eye socket. Medical doctors from the University of California, San Diego, School of Medicine and University of Washington Medical Center published their findings on transorbital neuroendoscopic surgery (TONES) in the scientific journal Neurosurgery. It's long been possible for surgeons to access the brain through the nose, but apparently requires much more equipment and people. (This is fascinating on its own, but I also wanted the chance to post this great comic panel that Klint Finley used to illustrate his post about the research at Technoccult.) From UC San Diego Newsroom:
"By performing surgery through the eye socket, we eliminate the need for a full craniotomy, gain equivalent or better access to the front of the brain, and eliminate the large ear-to-ear scar associated with major brain surgery," said Chris Bergeron, MD, assistant professor of Surgery, Division of Head and Neck Surgery, at UC San Diego Health System.
To achieve access, the surgeons make a small incision behind or through the eyelid. A tiny hole is then made through the paper-thin bone of the eye socket to reach the brain. This pathway permits repairs to be made without lifting the brain. The TONES approaches also protect the optic nerves, the nerves for smell, as well as the carotid and ophthalmic arteries.
"This approach has opened a new field of brain surgery," said study investigator, Kris Moe, MD, chief of the Division of Facial Plastic and Reconstructive Surgery and professor of Otolaryngology at University of Washington Medical Center. "The advantages to this transorbital approach are many, including reduced pain and decreased recovery time for the patient."