Sam Barnett, M.D. Answers Questions On: Neurological Surgery

Our Comprehensive Skull Base Program is for patients who have tumors, or other complex problems like traumatic injuries or a spinal fluid leak, that require more than one specialist’s care. It’s a team approach that includes neurosurgeons, ophthalmologists, and otolaryngologists, among others. Instead of mixing and matching doctors and appointments, patients can come see us all in one coordinated effort. We don’t have to redo or repeat things and the patient doesn’t have to go to different places. It’s good for the patients. They receive excellent care and it’s been a successful program.

The unique thing I have that not everyone can offer is endoscopic minimally invasive techniques. I also have the collaboration of my ENT colleagues at any given time. And I offer radiosurgery.

For me, since I’m comfortable with both the standard open approaches and minimally invasive ones as well as radiosurgery for brain issues,  I can offer the patient what is best, not just one size fits all. I can decide what is the best for that person and I’m not limited by what I can do.

The most common tumor we remove like this is the pituitary tumor, but it is also used to remove meningiomas, chordomas, and chondrosarcomas.

Determining when it can be used depends on the tumor and the person to receive the surgery. It has to be customized to the particular patient. So some tumors are suitable and some are not. Also, some patients are more interested in this approach, others are not. It just depends. It’s an option for almost every pituitary tumor, but it depends on the tumor and the patient in nearly every other case.

I use the Gamma Knife technique sometimes as the initial treatment for a brain tumor, but, more often, it’s used after surgery to remove residual tumor or if a tumor grows back.

Yes, and I’m often able to help them. One surgeon’s “inoperable” is not necessarily always the case.

We are in it right now with endoscopic surgery. It’s in the explosion phase, and it’s great to be able to have the experience we have in this area and offer it to patients.