A team of neurosurgeons at Apollo Cancer Centres (ACC) in Chennai successfully removed a deeply seated insular brain tumor from a 44-year-old woman using an innovative eyebrow keyhole approach. This pioneering technique became the first of its kind globally, marks a groundbreaking advancement in neuro-oncology.
The woman’s tumor was reportedly discovered incidentally during a check-up following a bike accident. Doctors at ACC identified the growth in the delicate folds of the insular lobe on the dominant side of her brain. The insula, buried deep within the cerebral cortex, presented significant surgical challenges due to its proximity to critical areas controlling speech and movement and its dense network of blood vessels.
Traditional surgical methods for accessing the insula involve navigating through critical brain tissue and blood vessels, which can risk severe complications such as paralysis, stroke, and language impairment. These surgeries often require patients to remain awake, which adds to their distress and increases the risk of seizures and brain bulges.
Faced with these challenges, the surgical team decided to employ the eyebrow keyhole approach. This technique involves making a tiny incision in the eyebrow to access the insula, leveraging the team’s extensive experience with keyhole surgeries for skull base lesions. This novel approach provided a minimally invasive alternative to traditional methods, aiming to reduce collateral damage and enhance patient safety.
Dr. Hrishikesh Sarkar, Senior Consultant in Neurosurgery at Apollo Cancer Centres, highlighted the significance of this achievement. “The eyebrow keyhole approach offers a transformative alternative to reach these deep-seated tumors inside the brain, minimizing invasiveness, reducing collateral damage, and significantly enhancing patient safety and overall quality of life,” he said.
According to reports, the patient was discharged from the hospital within 72 hours and is now recovering well. Expressing her gratitude, she noted that the advanced treatment not only healed her but also “gave me hope, comfort, and a shorter return to normalcy.”
The Eyebrow Keyhole techique is a minimally invasive neurosurgery that is used to treat brain tumours and intracranial pathologies. This approach usually involves making a small incision in the natural crease of the eyebrow to gain access to the patient’s brain. The small incision enables this access through a keyhole opening in the skull of the individual. However, the surgery includes an elaborate procedure and pre-planning. It employs detailed imaging studies such as MRI or CT scans to determine the exact location, size and characteristics of the tumor. The surgery may also involve neuronavigation systems for orecise surgical planning.
This technique has proven to be very efficient in the medical field, with Apollo Cancer Centres now effectively putting the technique to use. Amongst the several benefits of this approach to treating tumor, this surgery has a shorter recovery period since there is a smaller incision and reduced tissue disruption. It offers precision and is usually less painful after the operation. It also is less likely to cause infection or any other complication such as cerebrospinal fluid leaks.
However, as beneficial as this surgery may be, it might not be suitable for all the patients or the different tumor types. More serious or deeply rooted tumors may require more extensive surgical approaches. Besides these, another major factor that can contribute as a limitation to the eyebrow keyhole surgery, include the surgeon’s expertise and eperience with the techniques that are crucial for the success of the procedure.
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