Trigeminal Neuralgia: A Minimally Invasive, Endoscopic "Keyhole Approach" for Neurovascular Compression Syndromes

The endoscopic approach is being performed at the Skull Base Institute to surgically treat trigeminal neuralgia, utilizing the most highly advanced and minimally invasive techniques available. Trigeminal Neuralgia is universally acknowledged as the most painful affliction known to adult men and women and affects thousands of Americans each year. The episodes of intense, stabbing, electric shock-like facial pain are caused when a blood vessel comes in contact with the fifth cranial (trigeminal) nerve, applying pressure to the nerve. Patients with neurovascular problems such as trigeminal neuralgia, hemifacial spasm, intractable vertigo and spasmodic torticollis benefit tremendously from the Skull Base Institute's innovative endoscopic "keyhole" approach to these disorders and spend less down time, with fewer complications.

At The Skull Base Institute, Dr. Shahinian performs this delicate microvascular decompression procedure through a dime-size keyhole opening behind the ear. Through this opening, he inserts a 2.7 mm endoscope. Dr. Shahinian can then identify the problem and perform the surgery - meticulously separating the nerve and blood vessel, and inserting a Teflon disk between them. Once the pressure has been relieved, patients usually report immediate and complete relief from the pain. In many cases, the endoscopic "keyhole" surgery for trigeminal neuralgia is the preferred approach over traditional methods, in which metal retractors and instruments are inserted thru a much larger opening behind the ear, and the brain is pushed aside to reach the nerve compression area.

Since the introduction of the minimally invasive, endoscopic “keyhole” approach, numerous presentations have been made nationally and internationally to both colleagues in the field and patients suffering from neurovascular compression syndromes, such as Trigeminal Neuralgia. Video tapes of the procedure have been requested by both the National Trigeminal Neuralgia Association and several of their regional support groups. These videos can also be viewed on the Skull Base Institute website in the dedicated Trigeminal Neuralgia treatment section.

Pituitary Tumor: Endoscopic Procedure Revolutionizes Pituitary Surgery at the Skull Base Institute

One of the most extraordinary advances pioneered at the Skull Base Institute is the minimally invasive, fully endoscopic approach to treating pituitary tumors and other skull base disorders. This innovative procedure utilizes a tiny endoscope - 2.7 mm wide and 20 cm long - with an angled tip that is inserted through the nostril and into the skull base. This next-generation surgical approach to treating pituitary tumors offers numerous advantages in terms of decreased complications and recovery period.

First, because the camera is positioned at the tip of the endoscope, Dr. Shahinian has a vivid panoramic view of the brain. He can look around corners and make a full visual assessment. This panoramic view also provides Dr. Shahinian with the ability to remove the entire pituitary tumor, in most cases. The process is in sharp contrast to the traditional approach that requires viewing the tumor site through a microscope outside of the skull, which extensively limits visibility.

The point of entry for the Skull Base Institute’s minimally invasive, fully endoscopic pituitary surgery is through a nostril, so no incision is required. Consequently, there is no scarring, no nasal packing, and the brain is undisturbed. The time required for the actual surgical procedure, the length of hospital stay and overall recovery time are dramatically reduced. Patients return home within 24 hours of surgery, and return to work and normal activities within a week. Since the minimally invasive, endoscopic approach to pituitary tumors started at the Skull Base Institute in 1994, numerous presentations have been made nationally and internationally to both colleagues and patients suffering from pituitary tumors. Articles, videos and 3-D animations of the procedure have been requested by the world-renowned Pituitary Network Association, several of their regional support groups and major media outlets such as CNN and the Ellen DeGeneres Show. This information can also be viewed on the Skull Base Institute website in the dedicated Pituitary Tumor treatment section.