KEYHOLE CRANIOTOMY: A MODERN, MINIMALLY INVASIVE TECHNIQUE FOR SAFE BRAIN TUMOR REMOVAL

The Neurosurgery & Spine Department at Nam Sai Gon International General Hospital recently performed a successful keyhole craniotomy to remove a brain tumor compressing the optic nerve, which had been causing progressive vision loss in a 54-year-old male patient.

Tumor Recurrence After Two Surgeries

Since 2023, Mr. V.C.T. (54 years old, Tay Ninh Province) had been diagnosed with a craniopharyngioma — a rare brain tumor located near the sellar region, an area critical to hormonal regulation and visual function. Although he had undergone two previous surgeries, the tumor continued to grow and press against the optic nerve, causing significant vision impairment.

In the past month, he began experiencing intense headaches, worsening blurred vision in both eyes, fatigue, and even altered consciousness due to pituitary dysfunction.

During his examination at the Neurosurgery & Spine Department of Nam Sai Gon International General Hospital, MRI imaging revealed a recurrent tumor in the sellar region measuring 2.6 x 3 x 3.5 cm — the direct cause of his symptoms.

“Craniopharyngiomas grow in and above the sella turcica, a small yet vital area in the brain that regulates many critical bodily functions”, said Dr. Le Kham Tuan, PhD, Head of the Neurosurgery & Spine Department. “This region is surrounded by delicate structures such as cranial nerves and blood vessels, so surgery must be extremely precise to avoid severe complications. In this case, previous surgeries made the procedure even more challenging”.

To address this, the surgical team used a high-powered surgical microscope and fine microsurgical instruments to delicately remove the tumor while preserving surrounding brain structures.

Keyhole Surgery via Eyebrow Approach

After thorough preparation, the surgical team — led by Dr. Le Kham Tuan, PhD and Dr. Duong Duc Anh, MMed, with support from the Anesthesiology Department — performed the keyhole craniotomy via eyebrow approach, a minimally invasive microsurgical procedure that avoids large cranial openings as required in traditional brain surgeries.

By making a small incision along the left eyebrow, surgeons accessed the tumor without the need for a full craniotomy. With microscopic magnification, they were able to clearly visualize and carefully separate the tumor from the optic nerve and nearby critical structures.

Successful Keyhole Brain Surgery by Nam Sai Gon Neurosurgery Team

Following a four-hour surgery, the close coordination between the Neurosurgery & Spine team and the Anesthesiology Department resulted in a successful outcome. The entire tumor was completely removed, relieving pressure on the optic nerves and offering Mr. T. the possibility of visual recovery. Postoperative results showed significant improvement in his headaches and vision, with no damage to any cranial nerves.

Thanks to the small incision hidden in the eyebrow, recovery was faster, pain was minimal, and cosmetic outcomes were excellent. At follow-up, the patient was stable, with improved vision and no neurological complications.

“Craniopharyngiomas and other sellar-region tumors are dangerous but treatable if detected early”, emphasized Dr. Tuan. “Common symptoms include headaches, blurred vision, and menstrual irregularities in women. Anyone experiencing these signs should seek medical evaluation promptly”.

Nam Sai Gon International General Hospital accepts both public health insurance and private health insurance.

Nam Sai Gon International General Hospital

No. 88, Street No. 8, Trung Son Residential Area, Binh Hung Commune, Ho Chi Minh City.

Hotline: 18006767

info@nih.com.vn

BRC: No. 0312088602, issued on December 14th, 2012 by the Department of Planning and Investment of Ho Chi Minh City. Medical Examination and Treatment License No. 230/BYT-GPHĐ, issued by the Ministry of Health.