In 2010, when he was 68 years old, retired postal clerk Jutung Chu knew something was wrong, but he wasn’t sure what. He felt dizzy, unbalanced and just a little “off,” so he made an appointment with his primary care physician. After that physician ruled out a stroke and inner ear condition, he ordered an MRI, which revealed a tumor on the pituitary gland, in the center of Chu’s brain behind the nose and eyes. The tumor was growing in the part of the brain that regulates the body’s balance of hormones. Chu was relieved to know it was benign (non-cancerous), and he spent the next four years having annual MRIs to monitor its growth.
When the tumor began affecting his vision in 2014, Chu’s primary care physician suggested he see a neurosurgeon. Chu remembered reading an article in the November 2013 edition of Suburban Hospital’s community newsletter New Directions about neurosurgeon Shih-Chun (David) Lin, M.D., Ph.D., and quickly got in touch with him.
Dr. Lin recommended that Chu have the tumor removed before it caused irreversible damage to his optic nerve. He also explained that he would take a team approach to the surgery, operating with rhinologist and endoscopic skull base surgeon, Murugappan Ramanathan Jr., M.D. Using guided imagery and special tools, Dr. Ramanathan would open a path to the brain through Chu’s nose and sinuses and Dr. Lin would then remove the tumor. Called natural orifice surgery, no incision would be necessary, thereby allowing Chu to avoid a craniotomy, which involves shaving the head, removing a piece of the skull and going deep into the brain to reach the pituitary tumor.
Although Chu and his wife were quite nervous at the prospect of brain surgery, they were pleased to hear that the two physicians had done many of these procedures together at Suburban Hospital and The Johns Hopkins Hospital. It was also good to know that the endoscopic technique would result in a faster recovery and better outcome than more traditional ways of removing a pituitary tumor.
Dr. Lin explains, “A specialized procedure, done one hundred percent endoscopically, allows us to see the tumor better and achieve a complete resection (removal). If done with a microscope, which is how this surgery is performed traditionally, there is a good chance that part of the tumor could be left behind to continue growing, so we much prefer the endoscopic method. In addition, we also use an advanced technology called stereotactic navigation, which enables us to perform the surgery with the utmost accuracy to avoid injuries to nearby critical structures, such as the internal carotid arteries.”
(Johns Hopkins Medicine)
