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Published:  February 9, 2011

St. Luke’s Episcopal Hospital Offers Effective, Minimally Invasive Treatment of Pituitary and Other Skull-Based Tumors with NICO Myriad™

St. Luke’s Episcopal Hospital (SLEH) is the first in the Southwest to offer a new surgical device that enables neurosurgeons to perform brain tumor surgery more safely and effectively and less invasively. The NICO Myriad™ has been used to successfully remove tumors located in areas of the brain and skull base that are otherwise difficult to reach. It is ideal for use in endoscopic approaches, where neurosurgeons use specially designed cameras and instruments to operate safely in areas deep within the brain and skull, often with a very small incision, or through the nose with no incision at all. These approaches are particularly useful for pituitary tumors, meningiomas and other tumors in deep locations in the brain and skull base. Many of these tumors are benign and can be cured with successful surgery.

“The Myriad enables us to use endoscopic approaches to remove challenging pituitary and skull base tumors that in the past required making large incisions and skull openings,” says Daniel Yoshor, MD, Chief of Neurosurgery Service at SLEH and Associate Professor of Neurosurgery at Baylor College of Medicine. “The minimally invasive endoscopic option permits better tumor visualization and more complete tumor resection while at the same time enabling patients to recover more quickly, so they can get back to their daily lives. Our multidisciplinary team at SLEH is already one of the most experienced in the region in successfully removing skull base and pituitary tumors though an entirely endoscopic approach. The new addition of the Myriad further enhances our ability to carry out these operations, to the benefit of our patients.”

The Myriad’s slender design and malleable tip allow surgeons to operate through narrow surgical corridors, reducing the risk of injury to important neurovascular structures. The device enables surgeons to precisely remove even firm and difficult to resect tumors, by precisely shaving tumor tissue located near or even directly on critical structures, such as optic nerves and carotid arteries – without generating heat or  ultrasonic energy that can damage delicate structures in the brain. The Myriad is the first automated, non-heat generating tumor removal device to operate in open and endoscopic surgical approaches, giving surgeons the ability to treat a wide spectrum of tumors.

Considered a healthy 57-year-old, Sheila Birenbaum was diagnosed with a tumor the size of a walnut that was pressing against her optic nerves and threatening her vision.  In February 2010 she underwent traditional surgery to remove the tumor, but less than one-third of the tumor was removed and her optic nerve was still compressed and threatened by the large residual tumor.  Turning to Dr. Yoshor, Birenbaum underwent a second surgery in August 2010, this time via an endoscopic approach through the nose with no incision, and utilizing the new Myriad. 

“I had a totally different surgical experience with the Myriad,” said Birenbaum.  “I was much more comfortable immediately following the procedure and had a dramatically shorter and easier recovery. I was discharged home from SLEH two days after surgery, and within a few weeks, I was out digging a ditch in my yard.”  The endoscopic approach coupled with the Myriad required no incisions and removed the entire tumor, without the need for radiation.  Today, Birenbaum is completely free of the tumor and is back to enjoying a full and active life, with completely normal vision.

Yoshor added, “While many tumors exhibit a soft texture, Sheila’s tumor was an unusually firm mass that was difficult to resect with standard techniques and instrumentation; however, the Myriad precisely cut through the solid tumor and allowed us to safely remove the entire mass while preserving the critical visual pathways.”

The addition of the NICO Myriad is another important step in SLEH’s strategic focus on “minimally invasive and maximally effective” treatments of neurological disorders. In 2010, SLEH purchased the first CyberKnife® in the Houston area. The CyberKnife’s unique technology allows precise stereotactic radiosurgery treatment without the discomfort of having a frame bolted to a patient’s skull. It also allows doctors to reduce the risk of radiation injury to the brain by dividing treatments into several sessions. “The St. Luke’s NeuroScience Center strives to be well rounded, and provides patients with a multi-disciplinary approach along with the newest and best technologies for challenging tumor cases. These cases are reviewed by SLEH doctors from multiple specialties in our Neuroscience Tumor Board, and patients are offered the best possible treatments,” says Andrew Meade, Director of the Neurosciences at SLEH.  For more information about SLEH treatment options with the Myriad and with the Cyberknife, contact the St. Luke’s NeuroScience Center at 832-355-2187.

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