About This Project

Brain tumors are the 2nd leading cause of cancer-related deaths in children and in males ages 20-39.

Lesions of the skull base present unique challenges to neurosurgeons, who must perform intricate procedures within the smallest recesses of the brain. These procedures require a high degree of dexterity as well as a thorough understanding and visual grasp of the complex microanatomy of the skull base. Skull base surgery is undergoing a transformation where minimally invasive techniques are replacing open surgery. Highly specialized neurosurgeons can now remove unimaginably large tumors through penny-sized openings or even through the nostrils, using the natural openings of the face, with the use of tiny endoscopes. Your tax deductible donation will help to advance the field of neurosurgery and improve patient outcomes through the development of new safe and minimally invasive techniques for operating on the brain and skull. To see for yourself how we will accomplish this, click here.

Ask the Scientists

What is the context of this research?

We aim to develop 3 new safe and effective minimally invasive neurosurgical techniques that would potentially reduce complications and recovery time, and improve overall outcome. Additionally, we will attempt to integrate a synthetic tumor model into our projects that may decrease the learning curve for developing neurosurgeons.

Objective 1: Develop a Minimally Invasive Interhemispheric 3D Endoscopic Fenestration of the Lamina Terminalis through a Single Frontal Burr Hole

Hydrocephalus, an abnormal accumulation of cerebrospinal fluid in the brain, is one of the most common conditions that neurosurgeons treat. There are a number of safe and effective procedures for the treatment of hydrocephalus. However, anatomical variations of certain anatomical structures may hinder the standard methods of treatment in a select population of patients. We will attempt to develop and evaluate the feasibility of a novel alternative surgical procedure, performed through a single small opening, that is as simple, safe, and minimally invasive as the classic treatment options.

Objective 2: Develop a 3D Endoscope-Assisted Transcallosal Approach to the Third Ventricle Using a Minimally Invasive Tubular Retractor System

Surgical approaches to deep-seated brain pathologies and specifically lesions of the third ventricle have always been a challenging for neurosurgeons. The third ventricle resides in the center of the brain and is surrounded by vital structures, including the hypothalamus and thalamus, and important glandular structures, including the pituitary and pineal glands. We will attempt to develop and assess the feasibility of a new 3D endoscope-assisted procedure. We will utilize a newly applied tubular retractor system that may reduce intraoperative damage to brain tissue.

Objective 3: Develop Minimally Invasive Microscopic and Endoscopic Techniques for Optic Nerve Decompression

The visual system may be affected in cases of closed head trauma or compression of the nervous structures by a tumor. The optic nerve, responsible for vision, may require surgical decompression in cases of traumatic or indirect injury to a specific area of the nerve. We will attempt to achieve decompression of the optic nerve microscopically, through a small supraorbital bone opening, and endoscopically, though small bone opening on the side of the skull.

Objective 4: Integrate a Synthetic Tumor Model into the Technical Assessments of the Proposed Procedures and into our Postgraduate Neurosurgical Training Program

We will attempt to inject a synthetic polymer into our anatomical specimens in order to closely mimic intracranial tumors. The presence of a synthetic tumor will help in assessing the effectiveness of the proposed procedures and may help decrease the learning curve for neurosurgical procedures when integrated into a postgraduate neurosurgical training program.

All results will be submitted to respected peer reviewed journals for publication.

What is the significance of this project?

Over 2 million neurosurgical procedures are performed on patients in the U.S. every year (Source: AANS). Traditionally, neurosurgery consisted mainly of open surgery, including craniotomies and craniectomies, in which a portion of the skull is removed to allow the neurosurgeon access to the brain and skull base. As technology has advanced and instruments and tools have become smaller in size, neurosurgeons have adapted to using ultra fine tools that require smaller incisions. Neurosurgeons often operate using a microscope and/or endoscope, a small lighted probe with a camera, to visualize the tiniest of brain and spine structures. Modern technological innovations in neurosurgery – including 3D microscopy and endoscopy, virtual reality, surgical simulation, surgical robotics, and advanced neuroimaging – have created a multifaceted surgeon-computer relationship. For developing neurosurgeons, such tools can reduce learning curves, improve conceptual understanding of complex anatomy, and enhance visuospatial skills. This is clinically beneficial, as quality of neurosurgical care and patient outcomes are inextricably linked to surgical and technical proficiency and a thorough working knowledge of microsurgical anatomy. The development of novel technologically-integrated less and minimally invasive techniques will likely result in reduced trauma to the brain, potentially decreasing complication rates, improving recovery time, and providing better overall outcomes.

What are the goals of the project?

Primary Goal: $5,500

Initial development of novel neurosurgical techniques on cadaveric specimens, including the development and application of:

· A minimally invasive 3D endoscopic technique for fenestration of the lamina terminalinalis through a single small opening

· A less invasive 3D endoscopic technique for fenestration of the corpus callosum

· Minimally invasive microscopic and endoscopic procedures for decompressing the optic nerve through a small bony opening

· Application of a synthetic tumor model in technical assessment as well as postgraduate surgical education

The budgeted goal for accomplishing these projects includes funding a researcher, acquisition of a cadaveric specimen and surgical instrumentation/materials, and graphic design and publication costs.

Secondary Goal: $7,500

· Exploration of new neurosurgical approaches for the treatment of brain stem tumors with application of the aforementioned synthetic tumor model.

Tertiary Goal: $10,500

· Definition of optimal surgical strategies for the treatment of pineal tumors (germinomas) in pediatric patients

· Definition of optimal surgical strategies for the treatment of hypothalamic tumors (hamartomas) in pediatric patients

The budgeted primary goal for accomplishing these projects includes funding a researcher, acquisition of a cadaveric specimen and surgical instrumentation/materials, and graphic design and publication costs. Funds raised for secondary and tertiary goals will go towards specimen acquisition and project related material expenses.