Minimally Invasive Keyhole Brain Surgery

Surgery for brain tumors, skull base tumors and pituitary adenomas is a highly specialized area of neurosurgery that continues to rapidly evolve. At the BTC, we incorporate cutting edge technology and instrumentation with proven surgical experience to make surgery safer, less invasive and more effective. Given advances over the last decade, most tumors can now be removed via a keyhole approach through a small craniotomy (bony opening in the skull) or the nostrils.

The ideal approach is determined by the specific tumor anatomy in each patient. These include the endonasal endoscopic (through the nostrils), supra-orbital (through the eyebrow), retromastoid (behind the ear), mini-pterional route (in front of the ear) and other keyhole and conventional craniotomies.

Regardless of the route chosen, our goals are to maximize tumor removal and minimize manipulation of critical structures, thereby avoiding complications and patient disfigurement, while promoting a more rapid, complete and less painful recovery.

Notably, endoscopic and other keyhole approaches are technically demanding, require specialized instrumentation and are not appropriate for all brain tumors. Consequently, there remains a role for conventional larger craniotomies especially when the tumor itself has created a path through the brain or bone. Our BTC Director, Dr. Daniel Kelly has extensive experience with both conventional and keyhole approaches totaling over 4000 such procedures over the past 18 years. This large experience allows us to provide a truly tailored approach best suited for each patient.

Keyhole Surgical Approaches

Endonasal Endoscopic Surgery (through the nostrils)
For pituitary adenomas, craniopharyngiomas, chordomas, sinus carcinomas, olfactory neuroblastomas and midline meningiomas

Supraorbital Eyebrow Craniotomy For meningiomas, craniopharyngiomas and other tumors near the optic nerves and pituitary gland, as well as gliomas and metastatic brain tumors in the frontal and temporal lobes

Retromastoid Craniotomy (behind the ear)
For acoustic and trigeminal schwannomas, meningiomas, epidermoid tumors, and tumors of the cerebellum such as hemangioblastomas and metastatic brain tumors

Other Key-Hole & Conventional Craniotomies
For meningiomas, gliomas (astrocytomas, ependymomas, oligodendrogliomas, intraventricular tumors) and metastatic brain tumors