rEdEFInIng - Stanford Hospital & Clinics

NEURoLoGY
A BETTER WAY To do IT
Surgery of any kind near the brain stem carries precipitous risks of damage
with catastrophic consequences. Traditionally, neurosurgeons have taken
their instruments to that area only through the mouth or the side of the neck,
although both approaches risk adverse effects on swallowing, breathing and
speech, and require a long recovery. Surgeries that go through the nasal
passages to the eye and the brain have been possible only in the last decade
or so. New imaging technologies and new, extended surgical tools are more
flexible, optically sharper and much, much smaller. At Stanford Hospital,
endonasal surgery is thriving, with vibrant collaborations between the
Neurosurgery and Otolaryngology Departments.
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forging
DR. STEFAN MINDEA HAS PIONEERED NEW
TECHNIquES TO DECREASE RISk DuRINg
BRAIN AND SPINAl SuRgERY WHIlE INCREASINg
PATIENT COMFORT THROugHOuT RECOVERY.
Return to TOC
nEW
pathsTO
SuCCESS
“This surgery meant going home sooner
and with much less pain and fewer risks
of complications.”
Dr. Stefan Mindea
Director of the Neurosurgery Department’s
Minimally Invasive Spinal Surgery Program
Sandi Wearing’s MRI showed a mass at the very top
of her spinal column, providing one possible explanation
for what was making her speech difficult and her arms
weak. At Stanford, Sandi found two physician-scientists,
Dr. Stefan Mindea and Dr. Jayakar Nayak, who would
save her speech with an advanced surgical procedure that
reached her spine through her nose and sinuses. Never
before done at Stanford, the endonasal odontoidectomy
is a rarely performed procedure. There are just a handful
of medical centers anywhere that can accomplish this level
of endonasal surgery.
A chance meeting in the faculty lounge brought together
Sandi’s surgeons—Dr. Mindea, Director of the Neurosurgery
Department’s Minimally Invasive Spinal Surgery Program, and
Dr. Nayak, Co-director of the Otolaryngology Department’s
Stanford Sinus Center. Dr. Mindea was frustrated with the
surgical routes typically used to reach the spine through the
mouth or neck. Dr. Nayak, who regularly performs transnasal
sinus and skullbase surgery, knew how to reach the spine
through the nasal cavity. “For the right patient, you can
get to a site of interest with much less pain and dissection
through normal tissues,” says Dr. Nayak.
With a new path identified, Dr. Mindea was confident he
could cut down his patient’s recovery time and increase
her comfort. “This surgery meant going home sooner and
with much less pain and fewer risks of complications,”
he says. The successful surgery safely removed the mass.
Sandi has been speaking confidently and using her arms
freely ever since.
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