Recently, a man played the saxophone during a nine-hour surgery where doctors opened his skull to test the safest limits to access his brain and remove a tumor. Known as an awake craniotomy, the procedure has historically given patients the task of doing everything from playing the violin or guitar to stuffing olives, allowing doctors to monitor the function of their brains during the operation.
Dr. In an interview with CBS News, Christian Brogna reported that the vigilant brain surgery performed on the 35-year-old musician was successful. Although it was a complicated operation, Brogna was able to remove the tumor without any adverse side effects.
Brogna said: “The tumor was located in a very complex region of the brain. Moreover, the patient was left-handed. That makes things more complicated because the neural pathways of the brain are much more complex.”
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Why are they doing brain surgery while awake?
Being conscious when you know that there is someone inside your brain at that moment must be quite a difficult situation to accept. But this unconventional approach to tumor removal is seen as an effective way to assess which parts of the vital organ can be cut without losing function. Tumors and healthy brain tissue look extremely similar to the human eye, and so separating the two puts surgeons at risk of cutting out functional tissue vital to cognitive or motor function.
Being vigilant during the cutting phase of surgery means that patients have the opportunity to show signs of loss of function before it’s too late. Awake craniotomies typically involve anesthetizing patients while surgeons cut through the skull to gain access (which would be an excruciatingly painful process for an awake patient). They can then work on the brain while the patient is awake without the pain receptor.
Surgeons can test the effects of cutting parts of the brain by applying small electrical currents to stimulate tissue. If a patient reacts negatively to this part of the brain being stimulated, the surgeon knows not to cut that part of the brain.
These tests are conducted with speech therapists who continually test the awake patient for three types of errors in their speech. The first error is semantic, that is, the patient gives an incorrect answer when describing an object, but the word he says during this incorrect answer is associated with the correct answer. For example, the patient may say “fork” when shown a picture of a spoon.
The second error is phonemic (phonemic), meaning wrong and correct answers are phonetically similar words. An example of this is saying “stone” when the correct answer is the head. The patient is often completely unaware that he is saying the wrong words at this time.
The third type of error is cessation of speech, that is, when trying to respond, the patient completely loses the ability to speak. This situation is noticed by the patient and can be a cause of great stress. Therefore, an extensive interview process is involved before patients are selected for an awake craniotomy to assess whether they can emotionally cope with the stress of such a strange and unpleasant procedure.
While undoubtedly a worrisome procedure, operations like this can save people from dangerous tumors without reducing their quality of life. Surgeons listening to a saxophone concert during their work can only be described as a bonus.
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