New NYP course: Surgical approaches to the skull base

Mar 8 2009

The skull base is not just a simple platform for the brain but an anatomically intricate area with an array of connections necessary to the body's essential functions.

Traditionally, a tumor or aneurysm in this area was either inoperable or involved significant risk. Now, new surgical techniques -- including procedures done through the patient's eye orbit, ear and nose -- are greatly improving patient outcomes. However, the skills necessary for it require intensive training.

NewYork-Presbyterian Hospital/Weill Cornell Medical Center recently organized a medical education course called "Surgical Approaches to the Skull Base," to train neurosurgeons and ENT surgeons in the subspecialty. Notably, course participants used a custom 3-D visualization tool to learn about the complex surgical techniques. There were 30 attendees representing 10 countries across five continents. It was the third such course organized by the Department of Neurological Surgery at Weill Cornell.

"With rapidly emerging advances in imaging, instrumentation and techniques, we are now able to access the skull base in ways never before thought possible," said Dr. Philip E. Stieg, course director, chairman of the Department of Neurological Surgery at Weill Cornell Medical College and neurosurgeon-in-chief at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. "Mastering these is an integral part of providing patients with the best available treatment options and outcomes."

"In the old method, a lesion in the skull base could only be accessed from above by pushing aside the brain, something that risked neurological damage," said Dr. Antonio Bernardo, course director, assistant research professor of neurological surgery at Weill Cornell Medical College, and director of the microneurosurgery skull base laboratory at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. "New skull base surgery techniques reduce this risk and improve recovery for patients. However, they require that the surgeon have a high degree of dexterity with surgical instrumentation, and a deep knowledge of the skull's complex anatomy -- something our course was designed to impart."

To this end, Drs. Stieg and Bernardo offered a custom 3-D virtual-reality environment called IVD (interactive virtual dissection). Participants wore 3-D goggles during lectures and demonstrations. According to Dr. Bernardo, who developed the technology, the IVD system allows them much more time to familiarize themselves with the techniques before they perform actual dissections and surgeries.

Also participating in the event was Dr. Samuel H. Selesnick, professor and vice chairman of the Department of Otorhinolaryngology at Weill Cornell Medical College, and otorhinolaryngologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

The course took place Feb. 6-8 at the Palm Beach Gardens, Fla., campus of the Anspach Companies, a surgical device maker, which also sponsored the course. Additional sponsors included Zeiss AMT, Integra BrainLAB, Bracco TruVision and Stryker.

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