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Skull Base Brain Tumor Research

Winter 1999 Update
By Hrayr Shahinian, MD

While diversity is an apt term to describe the field of skull base surgery at large, momentum is the word that best captures the current pulse of the Skull Base Institute. On all fronts, progress is occurring in leaps and bounds.

Clinically, we have met our half-year goal in terms of the number of cases we intended to log. By years end we hope to meet, if not exceed, our projected operative goals. More and more of our referrals now are coming from physicians whose patients have returned to them with positive reports of their experiences. This indicates a greater awareness of the efficacy of skull base techniques in the management of diseases that are still considered by some to not be amenable to surgical intervention.

In previous issues of Head Lines we have described our collective efforts in the laboratory and the operating theater geared toward the establishment of fully endoscopic pituitary surgery as our standard of practice for resection of pituitary lesions. We are happy to report that since our last release, Endoscopic Pituitary Surgery at Cedars-Sinai Medical Center has become a reality. (Intraoperatively, we are implementing several instruments that we have designed either alone or in collaboration with Dr. George Berci (Professor Emeritus and Director of Endoscopic Research at Cedars-Sinai). These include endoscope holders, devices for cleaning the endoscopes in situ without removing them from their holders, and newly shaped curettes to facilitate tumor resection in the new endoscopic surgical field. Post-operatively, our patients have woken up from surgery almost entirely free of discom-fort with a minimal amount of postopera-tive pain. They have invariably been ready for discharge within 48 hours. This issue's "Case of the Month" illustrates this ground-breaking work.

We are actively looking to expand our fellowship program and recruit a second fellow for the 1999-2000 academic year. While our recent successes have been welcome, they have revealed to us how much work remains to be done in the laboratory.

We also look forward to the newest addition to the Skull Base Institute: Mrs. Nicole Evans. Nicole is a Clinical Level III Registered Nurse who has been working in the operating room as a circulating and scrub nurse for several years. She has demonstrated a genuine interest in the field of skull base surgery and in the care of our patients. We are honored that she has agreed to become our dedicated scrub nurse as well as the nursing coordinator of the Institute. Working in conjunct with our Nurse Practitioner, Ms. Fe Mangila, we will be able to offer our patients more efficient nursing services at all levels of their care.

In order to expose as many people as possible to the therapeutic possibilities offered in the field of skull base surgery, we have concentrated on reaching out to the community at large. Beginning this month we will be hosting the meetings of the West Los Angeles trigeminal neuralgia support group; in January we hosted a Trigeminal Neuralgia Workshop where speakers lectured on various aspects of the diagnosis and management of trigeminal neuralgia to 150 guests. Finally, as I have introduced to you before, next autumn we will be hosting the CME accredited fourth annual Skull Base Surgery Symposium, featuring internationally renowned key-note speakers who will present their perspectives on various topics in the field.