Brain surgery through the eyelids

April 15, 2009 3:19:55 PM PDT
More than half a million people will have brain surgery this year. Large scars and lengthy recoveries typically go along with the surgery, but doctors are now using the eyes as the gateway to the brain to make surgery less invasive. Swelling aside, you'd never guess Mike Hogan had life-saving brain surgery just a few weeks ago.

"The doctor ordered a CAT scan," Hogan said. "When they did the CAT scan, the aneurysm showed up."

Doctors determined the aneurysm was in danger of rupturing. Hogan's surgeons used a new and unusual technique to treat it.

"When we do the standard procedure, we make an incision behind the hairline," said Dr. Khaled Aziz, a neurosurgeon at Allegheny General Hospital in Pittsburgh, Pennsylvania.

Instead, surgeons fixed the aneurysm through a tiny hole in Hogan's eyelid. During the eyelid craniotomy, a neuroopthamologist marks the eyelid crease, then makes an incision and removes a small piece of bone from the patient's eye socket. Next, a neurosurgeon reaches the front of the brain, clips the blood vessel that feeds the aneurysm and then puts the bone back in place. Doctors say a smaller incision means a shorter hospital stay, faster recovery and less pain.

"In the long run, I think this is more helpful for the patient outcome rather than standard surgical approaches," Dr. Aziz said.

Hogan has no scar, little pain and, more importantly, more time to watch his grandchildren grow up.

"It's amazing what they can do," Hogan said.

Dr. Aziz says the eyelid approach is not for every patient. It only works for patients who need brain surgery toward the front of the skull. Neurosurgeons also use the eyelid surgery to operate on certain brain tumors.


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