Carrau Leads International Endonasal Endoscopic Skull-Base Surgery Conference A type of surgery not often done in the past because of its difficulty and complexity will now be more common, thanks to the pioneering work and teaching abilities of a professor at The Ohio State University Medical Center. Ricardo Carrau, MD, FACS helped develop a way to perform surgery on the base of the skull—the area between the face and the cranium. The technique utilizes the same kind of endoscope used to treat sinus conditions. Carrau, professor of Otolaryngology – Head & Neck Surgery and director of the Skull Base Surgery center, is working as part of a team with colleagues at the University of Pittsburgh, where he was on staff prior to coming to Columbus. In October, he directed and taught at the First Endoscopic Skull Base Surgery Course presented by Ohio State’s Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, held here at the Center of Science and Industry (COSI). The four-day international conference was comprehensive, Carrau says, in emphasizing both the surgery and the technique for performing it. Skull-base surgery had been performed as an open procedure, but as a result of progress over time the new endoscopic approach makes it possible for physicians to reach affected areas via the nostrils. Many procedures previously done as standard surgeries can today be performed this way, Carrau adds.
techniques pertaining to the supraorbital keyhole craniotomy approach. Carrau’s team covered the nuances and technological requirements of the surgery. Along with the didactic and handson elements of the course, there was a link to a live surgery, and attendees could speak with the surgeons and others involved in the procedure. The course also touched on robotics, a technique that will complement endoscopy. In addition to Carrau, course directors were Bradley Otto, MD, assistant professor, Department of Otolaryngology Head & Neck Surgery and Daniel Prevedello, MD, assistant professor, Department of Neurological Surgery. Both also are members of Ohio State’s Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute (OSUCCC-James). College of Medicine faculty who are members of the OSUCCCJames were Mario Ammirati, MD, MBA, professor of Neurological Surgery and of Radiation Oncology; Steven Katz, MD, associate professor of Ophthalmology and director of Neuro-Ophthalmology; Matthew Old, MD, assistant professor, Department of Otolaryngology –Head & Neck Surgery; and Enver Ozer, MD, associate professor, Department of Otolaryngology– Head & Neck Surgery. Department of Anatomy research fellows were Leo Ditzel Filho, MD and Daniele de Lara, MD. Guest faculty members were Amin B. Kassam, MD, professor, Department of Neurosurgery, University of Ottawa, Ottawa, Ontario, Canada and Henry W.S. Schroeder, MD, PhD, professor and chairman, Department of Neurosurgery, Ernst Moritz Arndt University, Sauerbruchstr, Germany.
The technique causes less pain than open surgery, and recovery is faster. Minimally invasive surgery has been known for some time, and its benefits include less pain, less scarring and faster recovery. But Carrau doesn’t call this surgery minimally invasive; his term, since the method and the visualization are different, is “minimal access.” The conference, held October 6-9, 2011, drew 96 attendees— neurosurgeons, otolaryngologists,head and neck surgeons and other skull-base surgeons—from 15 countries. The course offered CCME (OSU Center for Continuing Medical Education) credit. This was a hands-on seminar, Carrau explains. It included lectures, dissection, and a 3-D anatomical presentation. A course brochure listed areas covered, including the following: indications for the procedure’s use; limitations and surgical techniques for skull-base endoscopic endonasal surgery, pituitary fossa, orbit and craniocervical junction; indications, limitations and
The Ohio State University Medical Center Department of Otolaryngology page 4