A surgeon at University of Louisville Hospital, part of KentuckyOne Health, recently performed an extended endoscopic skull-based surgery of the brain, a unique surgery of its kind in Kentucky.

Performed by Dr. Mary Koutourousiou, assistant professor of neurosurgery and director of the skull base program, the minimally invasive surgery was done to help restore the eyesight of a 34-year-old man who suffered from a malignant brain tumor located at the base of the skull.

Extended endoscopic skull-based surgery is performed through the nose and enables surgeons to remove brain tumors and lesions – some as large as softballs. During the procedure, which takes an average of six hours, surgeons use a specially designed endoscope to view the tumor and additional instruments to dissect it piece-by-piece through the nasal cavity.

This approach reduces risks and recovery times for the patient who would otherwise need a craniotomy, which requires temporary removal of a bone flap from the skull to access the brain and brain retraction to reach the tumor.

“The base of the skull is one of the most challenging regions of the body to access,” Koutourousiou said. “Using an endoscopic endonasal approach provides a panoramic view of the base of the skull and the patient’s tumor.”

The minimally invasive nature of the procedure leaves no visible scarring, shortens a patient’s hospital stay, reduces overall recovery times and involves less trauma to the brain and critical nerves. Hospital stays following a craniotomy could be up to 30 days, compared to three to four days following an extended endoscopic skull-based procedure.

“This approach is the future of brain surgery,” said Ken Marshall, president, University of Louisville Hospital. “There are only a handful of surgeons with fellowship training on this procedure in the country. We are proud to have one of those surgeons on our team and to be able to offer this new option for patients in the Commonwealth.”

Koutourousiou completed a clinical fellowship in endoscopic skull base surgery and open skull base surgery at the University of Pittsburgh Medical Center. She has published extensively on the endonasal approach to brain surgery.