Dr. Yaron Moshel of Atlantic NeuroSurgical Specialists (ANS) Discusses Brain Tumor Surgery

The ANS Skull Base Surgery Center offers hope for patients who suffer from brain tumors, acoustic neuromas, pituitary tumors, skull base meningiomas, trigeminal neuralgia, spinal fluid leaks, and aneurysms.

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The last decade has seen significant incremental advances in the treatment of brain tumors. We now have several tools with which to attack a tumor, and tumor surgery will continue to incorporate more and more functional brain data from advanced MRI scans.

Morristown, NJ (PRWEB) July 31, 2014

ANS and Dr. Yaron Moshel offer answers to some common questions they receive about the ANS Skull Base Center and what the future holds for Brain Tumor Surgery.

What is the ANS Skull Base Surgery Center?
Skull base surgery is a form of highly specialized brain surgery that reaches the undersurface of the brain, an area historically considered very delicate and relatively inaccessible. In the past, the only way to access these areas was by retracting healthy brain tissue, leading to more neurological damage. Modern philosophy is to remove bone under the skull or use high-tech cameras to access these regions through the nose—a safer, less risky approach. Some conditions that benefit from this type of surgery include brain tumors, acoustic neuromas, pituitary tumors, skull base meningiomas, trigeminal neuralgia, spinal fluid leaks, and aneurysms.

The ANS Skull Base Surgery Center offers a variety of surgical and nonsurgical treatments. We consist of several highly specialized experts: brain tumor neurosurgeons, radiation oncologists, neuro-ophthalmologists, otolaryngologists, and neurologists. With the collaboration of subspecialized, fellowship-trained physicians, brain tumor patients are guaranteed to receive the treatment that best suits their individual needs.

Why should a brain tumor patient come to see ANS?
The practice is pushing the envelope with CyberKnife® radiosurgery, a non-invasive treatment for certain tumors. Additionally, we offer endoscopic and minimally invasive techniques for the skull base and routinely perform brain tumor surgery with functional brain mapping techniques.

Which patients are candidates for endoscopic minimally invasive brain surgery?
The decision as to whether a tumor can be removed either through the nose or through the skull using an endoscopic camera can get very complicated and requires careful review of the MRI and consideration of the patient’s symptoms. We also use endoscopic surgery to treat other conditions that are not related to tumors, such as hydrocephalus and spinal fluid leaks.

When do you use radiosurgery for brain tumors?
On some occasions we use the CyberKnife as the initial treatment for a brain tumor, and on other occasions radiosurgery is used after surgery to treat any residual tumor. Having the CyberKnife as a treatment alternative allows us to perform safer surgery. For example, in a very delicate and sensitive brain region, it may be safer to only remove part of a tumor, reducing the tumor to a size that can be easily treated with noninvasive radiosurgery. Ultimately the patient benefits from this type of coordinated approach and it leads to more successful outcomes with safer surgery. The CyberKnife is also an important tool and noninvasive treatment option for tumors that grow back. Radiosurgery technology is rapidly advancing and we are very involved with the manufacturers in developing less invasive and more accurate treatments.

Do you see patients who have been told their tumor is inoperable?
Yes, and we are often able to help them. One surgeon’s “inoperable” diagnosis does not mean a patient should give up hope. Many surgeons are hesitant to remove a tumor if it’s too close to eloquent brain structures that control vision, language, and body movements. Even the slightest miscalculation could result in a significant loss of function. My approach is different. We map out these critical brain structures avoid them in order to protect them. By doing this, we are able to remove all or most of the tumor otherwise considered inoperable.

What is the next big thing in brain tumor surgery?
The last decade has seen significant incremental advances in the treatment of brain tumors. We now have several tools with which to attack a tumor, and tumor surgery will continue to incorporate more and more functional brain data from advanced MRI scans. For example, we can now map out the entire motor system, including all the connecting pathways in the brain, during surgery using a special GPS-like tracking device. We will soon be able to make sure that all of a tumor has been removed using special fluorescent dyes that make tumor tissue glow during surgery. But I think the most exciting advances are in the shift from “shotgun” chemotherapy that attacks all dividing cells in the body to highly targeted drugs that seek out and destroy brain tumors. These include the development of brain tumor vaccines which are still under trial and drugs that choke off the blood supply to brain tumors.


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