Many Mid-Southerners like Ann O’Leary suffer from allergies and sinus problems, so O’Leary did not think anything about it when she developed problems with her sinuses. However, her sinus troubles turned into more than she ever imaged – a tumor that stretched from her nasal cavity into her brain.

“I didn’t have any symptoms. No dizziness. No vision problems,” said O’Leary. “I was lucky to finally find it because I’d probably had it for a while.”

Fortunately for O’Leary two surgeons at Methodist University Hospital are among a select few who take a unique approach to removing tumors that extend from the nasal area into the brain. It's called the craniofacial approach; which involves cutting a hole in the top of the skull behind the hairline rather than breaking the bones in the face to reach the tumor.

“My surgery was very successful and I am feeling really good,” said O’Leary. “We are very fortunate to have such talented surgeons right here in Memphis.”

Madison Michael, M.D., medical director, skull base surgery at Methodist University Hospital Neuroscience Institute and assistant professor, neurosurgery at the University of Tennessee Health Science Center (UTHSC) and Sandeep Samant, M.D., chief, division of head and neck oncology at Methodist University Hospital and associate professor, otolaryngology, head and neck surgery UTHSC, both believe the craniofacial approach provides patients the best chance of removing the entire tumor.

“We feel that tumor control is the thing we are going after and the craniofacial approach we take gives us direct visualization of the tumor margins. So at the end of the day when we leave the operating room we know we’ve removed all of the tumor that was present,” said Dr. Michael.

Most surgeons cut apart the facial bones to remove a tumor that grows from the nasal cavity into the brain. This surgical procedure results in scarring the face and requires follow up treatments with chemotherapy and radiation. The craniofacial approach treats patients with chemotherapy and target radiation therapy to shrink the tumor before any surgery is done.

“Using chemotherapy and target radiation therapy to reduce the size of the tumor allows us to perform a more conservative operation,” explained Dr. Samant. “So we can do less surgery and still achieve the same results long term in terms of survival and control of the cancer.”

During surgery, an incision is made behind the hairline and a hole is cut in the skull. Through this opening, the entire tumor is removed. A neurosurgeon operates first removing the tumor that is in the brain. A head and neck surgeon steps in and removes the tumor that is in the nasal cavity. Patients are typically in the Neuro Intensive Care Unit for 48 hours before they are moved to the floor for about five to seven days.

“Dr. Michael and Dr. Samant just did a fabulous job,” said O’Leary. “I don’t think you can get better care anywhere else.”

Dr. Samant says he and Dr. Michael develop a treatment plan that is unique for each patient by using chemotherapy agents that are more effective and taking advantage of the advances and innovations that have occurred in radiation therapy and surgical techniques like intensity modulated radiation therapy (IMRT), and computer-assisted navigation. “To be able to do that and to help patients is obviously very exciting,” said Dr. Samant.

To watch surgical footage and to learn more about the craniofacial approach to removing tumors and the Methodist University Hospital Neuroscience Institute, go to neuro.methodisthealth.org.