Acoustic Neuroma

An acoustic neuroma is a benign tumor, usually stemming from the balance nerve, which travels from the brainstem to the inner ear.  It is also called a vestibular schwannoma. This tumor is often diagnosed when patients experience unilateral hearing loss. Management options included surgical removal, radio surgery (e.g. with the Cyberknife), and "watchful waiting." 

There are three main surgical approaches designed specifically for removing acoustic neuromas. Dr. Jean uses all three, including the retrosigmoid, middle fossa, and translabyrinthine approaches. He believes that the operation must be tailored to the individual patient's needs and tumor characteristics.

Meningioma

A meningioma is a tumor stemming from the covering of the brain, and usually, it is benign. However, a meningioma at the "skull base," the space between the bottom of the brain and underlying skull, can stick to or wrap around vital nerves and blood vessels in this space.

As such, meningiomas in areas such as the cavernous sinus, petous bone, clivus and posterior fossa, require exceptional level of experience and skill to remove. Depending on the location, the approaches that Dr. Jean uses for meningiomas include the orbitozygomatic, petrosectomy, and far-lateral transcondylar approaches.  

Pituitary adenoma

The pituitary gland controls most of the hormones in the body. Tumors of this gland can damage the body by over-producing hormones. As the tumor grows, it can also damage the patient's vision by pressing on the optic nerves. 

Unless it is very small and produces no hormones itself, a pituitary adenoma needs to be surgically removed. The operation is performed without incisions on the face or head, through the nasal sinus. Dr. Jean uses a high-tech endoscope, so that this operation can be done with minimal damage to the sinuses, allowing for easy recovery and quicker return to work and life.

Pineal mass

The pineal gland is situated approximately in the geometric center of the head. The region is surrounded by critical structures such as the brainstem, and major blood vessels such as the great vein of Galen.

Mass lesions in this region include tumors and cysts. Because of the location and the surroundings, operations in this area are very complex. Fortunately, modern technology such as "stealth" neuro-navigation and endoscopes, make these operations safer and smoother. The surgical approaches that Dr. Jean uses for this region include the occipital interhemispheric transtentorial, and supracerebellar infratentorial appraoches.

Neuro-endoscopy

Traditional approaches to the base of the anterior fossa (front part of the skullbase) require large incisions on the face. Currently, our state-of-the-art endoscope provides illumination and visualization, and allows us to approach the same regions through the nasal sinuses.

Disfiguring surgery through the face is a thing of the past. The Endonasal Endoscopic Approaches to the skull base can be used to remove tumors, and other abnormalities, and because there are no large incisions, healing is quicker and smoother.

Virtual and augmented reality

With Virtual Reality (VR), ordinary, black-and-white CT and MRI scans are turned into colorful 3-dimensional objects and patients can “fly through” their own skull or brain to get a sense of what is wrong, why they need surgery, and how surgery would work. VR also lets surgeons rehearse various operations to test out which one is most effective or least risky.

Augmented reality (AR) takes this further. Surgical targets, or vulnerable brain structures that are “no fly zones” during operations, are projected into the operative microscope. This lets surgeons perform operations with superman-like “X ray vision” to see through where they should or shouldn’t be.

Dr. Jean is one of the pioneers in this field, and he uses VR/AR to improve patients’ understanding of their problem and achieve the best surgical outcome.

Trigeminal Neuralgia

Also known as "Tic Doloreaux," the face pain in this syndrome may be the most severe pain that humans can experience. The typical pain is shock-like, and electric, involving one side of the face. 

When medications fail, surgical treatment can be effective to reduce or even cure the pain. Dr. Jean has extensive experience with Microvascular Decompression, the most effective surgical treatment of this syndrome. He also uses the CyberKnife for radiosurgery to treat trigeminal neuralgia.