AHEAD OF THE GAME: OUR OUTSTANDING SKULL BASE SURGERY TEAM

Macquarie University Hospital’s skull base surgery unit has a concentration of expertise that makes it the single biggest and most experienced in NSW, if not Australia. This means that the team can tackle complex cases using the latest procedures.

The expertise at Macquarie University Hospital’s rhinology and anterior skull base surgery unit is second to none. Located within the Department of Otolaryngology–Head and Neck Surgery at Macquarie University and engaged in clinical practice through the Hospital, the team is made up of five skull base surgeons, all of whom have completed multiple advanced international fellowships.

This level of combined skill and capability not only makes the unit a national leader, but brings patients treatment options that are on a par with the best available globally.

Trained at the best academic hospitals in America, UK and Australasia with world-leaders in advanced rhinology and endosopic skull base surgery, the Macquarie team can perform highly specialised procedures by advanced endoscopic skull base and orbital surgery techniques.

Done 100 per cent internally, an endoscopic approach uses the nasal cavity, paranasal sinuses or ocular walls to remove brain or eye tumours, including very large lesions on the anterior skull base. Using an endoscopic approach means radiosurgery and external craniotomy are avoided, less damage is caused to surrounding tissues and structures, and patients recover much faster.

“Besides the extensive training that the team has, what also makes us able to offer innovative approaches or take on high-risk cases is the multidisciplinary nature of the team that we can assemble,” said Professor Ray Sacks who is Head of Otolaryngology–Head and Neck Surgery at Macquarie University and a world-renowned rhinological surgeon himself.

“Our rhinologists can team up with oculoplastic, plastic and neurosurgeons in treating either particularly big tumours or complex cases.

“Macquarie University Hospital also has one of the most advanced neurosurgical programs in the country so by collaborating with them, we are able to offer patients what really is the best available by world standards.”

The team has access to Theatre 12: the Hospital’s dedicated neurosurgery and skull base surgery space. It is equipped with the latest endoscopes, multi-image guidance systems and an intraoperative CT scanner. Post-operatively, patients can be cared for in the ICU by specially trained nurses.

“Patients who otherwise would have had pretty invasive open surgery are able to be treated by our team through endoscopic means,” said Professor Sacks.
“As one example, we treated a woman in her sixties who had a very large adenocarcinoma on her skull base. Because endoscopic surgery allowed us to enter from below – as opposed to an external approach from the top of the head – we were able to resect successfully such a large tumour located so deeply at the base of the brain.

“Her recovery was remarkable, and she has no residual nerve or tissue damage that may have been caused by navigating through the brain to get to the tumour.

“In another case, we treated a medical student who had been viciously assaulted and suffered severe orbital fractures that led to persistent double vision and awkward cosmesis. She was scheduled elsewhere to have a craniotomy, which would have involved external incisions and elevation of the brain to access the damaged area.

“At Macquarie University Hospital, working with neurosurgeons, we were able to offer her an endoscopic approach, which also included releasing the entrapped extraocular muscles and reconstructing the bony orbit in this minimally invasive way. Today, she has no residual effects at all and is active in the medical workforce.”

A DEFINITIVE TEXT: ORBITAL SURGERY

Macquarie University’s Professor Ray Sacks and two Harvard University colleagues Professors Benjamin Bleier and Suzanne Freitag are co-authors of the newly released Endoscopic Surgery of the Orbit: Anatomy, Pathology, and Management.

Published by Thieme, the book is the benchmark reference on endoscopic surgery of the orbit. It focuses on surgical innovations in lacrimal and orbital surgery, including endonasal and transorbital endoscopic approaches to the orbital apex and skull base.

About Professor Ray Sacks

Professor Sacks is an internationally renowned rhinological surgeon. He was Chief Examiner in Otolaryngology–Head and Neck Surgery for the Royal Australasian College of Surgeons from 2012 to 2014 and President of the Australian and New Zealand Rhinologic Society from 2008 to 2013. He is Past President of the NSW branch of the ASOHNS Society. Professor Sacks has received multiple awards, including the Australian Society of Otolaryngology–Head and Neck Surgery Medal for Outstanding Contribution to the Art and Science of Otolaryngology¬–Head and Neck Surgery, the International Rhinology Society Medal for Distinguished Service to the International Rhinologic Community and, just recently, the NSW Royal Australasian College of Surgeons Merit Award for services to surgery.

JUST HOW HIGHLY TRAINED IS THE REST OF THE TEAM?

Professor Richard Harvey, Rhinologist and Skull Base Surgeon

Professor Harvey completed three consecutive fellowships. Initially studying with Professor Valerie Lund at University College of London and then with Professor Rodney Schlosser at Medical University of South Carolina (both world renowned rhinologists), he then elected to undergo a third fellowship under Professor Aldo Cassol Stamm at Sao Paolo in Brazil, widely regarded as the founder of modern-day endosopic skull base surgery. Professor Harvey is also one of only two specialist rhinologists to have completed a PhD in NSW and has published in excess of 150 peer-reviewed papers. He has co-edited the textbook Endoscopic Sinus Surgery Optimizing Outcomes and Avoiding Failures with Rodney Scholosser

Associate Professor Dr Yuresh Naidoo, ENT Surgeon

Associate Professor Naidoo is the second rhinologist in NSW to have earned a PhD and was extremely fortunate to have been granted a 12-month advanced fellowship in endosocopic skull base surgery and rhinology under one of the pioneers of endoscopic sinus surgery, Professor Peter John Wormald. Associate Professor Naidoo is also the Supervisor of Surgical Training in the Department of Otolaryngology at Concord Hospital and is a member of the regional training committee for ENT training in NSW.

Dr Arjuna Ananda, ENT Surgeon

Dr Ananda was the very first ENT Surgeon to have been given the opportunity to undergo a fellowship and advanced training in endoscopic sinus and skull base surgery under the tutelage of Professor Peter John Wormald who, at that time, was leading the world in his revolutionary approach to endosocopic surgery of the nose and paranasal sinuses. Dr Ananda is also the Head of the Department of Otolaryngology¬–Head and Neck Surgery at Royal Prince Alfred Hospital in Sydney and is actively involved in the training of ENT SET trainees.

Dr Raewyn Campbell, ENT Surgeon

Dr Campbell completed three back-to-back fellowships. Having trained under Professor Sacks at Hornsby and Concord Hospitals as a registrar, she then completed an advanced rhinology fellowship at Auckland City Hospital with Professor Richard Douglas, followed by a fellowship in rhinology and skull base surgery at the world-renowned unit at the University of Pennsylvania with Professor James Palmer. Finally, she completed her training with a further 12 months at Ohio State University Hospital/The James Comprehensive Cancer Centre with Professor Ricardo Carrau, who is regarded as the ‘father’ of anterior skull base reconstructive surgery.