Brain Tumor Surgery

Surgery is usually the first step in treatment of most of the benign and many malignant tumors. It is done to remove tumor while preventing any unnecessary risk of neurological damage.

Indications for Brain Tumor Surgery

• Take a tumor sample for an accurate diagnosis.
• Remove as much tumor as possible
• Provide direct access for chemotherapy, radiation implants, or genetic treatment of malignant tumors
• Relieve seizures and other symptoms of brain tumor
• To ease the pressure exerted by tumor on surrounding structures

Types of Brain Tumor Surgery

Any type of brain surgery is performed under anaesthesia. The main brain surgeries for brain tumor include the following:

• Biopsy: It is the procedure in which a sample of tumor tissue is taken for laboratory examination.
• Craniotomy: It is the procedure of removal of a portion of skull to find and remove the tumor as much as possible. This is followed by replacing of removed skull. It may be done by following techniques:  
  • Extended bifrontal craniotomy
  • "Eyebrow" craniotomy (supra-orbital craniotomy)
  • "Keyhole" craniotomy (retro-sigmoid craniotomy)
  • Orbitozygomatic craniotomy
  • Translabyrinthine craniotomy
• Craniectomy: It is a surgical procedure that is very similar to a craniotomy except that the removed portion of the skull is not replaced.
• Debulking: The surgical procedure to reduce the size of the tumor.
• Partial Removal: The surgical procedure that involves removal of only part of the tumor due to risk of neurological damage.
• Complete Removal: The surgical removal of the entire tumor.
• Shunt: The surgical procedure that involves insertion of a drainage system into the brain that will move excess fluid from the brain to another part of the body.
• Ommaya Reservoir: It is the procedure in which a small container is inserted under the scalp which is attached to a tube. This container can be used to:
  • Deliver chemotherapy drug to the brain and the surrounding cerebrospinal fluid (CSF)
  • Remove CSF to study cytology.
  • Remove cystic fluid without surgery.
• Skull Base Surgery: It is a surgical procedure that is performed to remove tumors of skull base.
• Transphenoidal Surgery: Surgical procedure to remove pituitary adenomas and craniopharyngioma.
• Laser Interstitial Thermal Therapy (LITT):  A minimally invasive procedure that involves ablation of tissue with heat.   
• Endonasal endoscopy (endonasal endoscopic surgery)
• Neuroendoscopy

Authored by Dr. Shyam Sundar K