HJAR Nov/Dec 2020

HEALTHCARE JOURNAL OF ARKANSAS I  NOV / DEC 2020 51 Ali Krisht, MD, FACS Director Arkansas Neuroscience Institute at CHI St. Vincent CHI St. Vincent Arkansas Neuroscience Institute’s (ANI) team of neurosurgeons, led by Dr. Ali Krisht, has developed the most advanced treatment for cavernous sinus patients. They are one of the few places in the world where microsurgical cures for se- creting pituitary adenomas of the cavernous sinus have been achieved. An area of the brain that was once thought to be inoperable and risky is now operable and safe. An extensive knowledge of the cav- ernous sinus region of the brain enables sur- geons at theArkansas Neuroscience Institute to navigate this area of the brain with maxi- mum precision, yielding superior results and quality outcomes for their patients. This area is composed of venous channels and pockets surrounding the carotid artery before it enters to the intradural cavity. The sixth nerve is inside the sinus, crossing over the carotid artery and the oculomotor and trochlear nerves; and the first and second division of the trigeminal nerves are parts of the lateral and superior walls of the sinus. The pituitary gland and optic nerves are in close proximity, and the sinus itself is covered laterally by the dura of the temporal lobe and superiorly by the anterior clinoid. Tumors such as meningioma, chordoma and hemangioma can grow in the cavernous sinus itself, and other tumors may extend to invade the cavernous sinus, which is located on each side of the sella turcica in a hidden location in the skull base that makes it dif- ficult to safely approach lesions involving the cavernous sinus. This deep location and complex anatomy of the cavernous sinus has driven surgeons away from performing surgery on patholo- gies involving the cavernous sinus to the extent where some called it “no man’s land,” leaving only a few in the world who perform surgery on the cavernous sinus. Anew surgical technique of the cavernous sinus has been simplified byANI by develop- ing strategies to control the bleeding from the sinus and preserving the anatomical and vascular structures involved, thus converting the “no man’s land” to an area where skilled surgeons can safely extract these tumors with minimal deficits to the patient. INCREASING LIFE EXPECTANCY FOR PATIENTS The combination of mastering the anat- omy of as well as developing an extensive knowledge of the disease state of the cavern- ous sinus has allowedANI neurosurgeons to unlock the complexities of this region. Their technique prevents patients from multiple recurrences, inhibiting the need for additional treatments and radiation while improving quality of life and increasing life expectancy. Because of the advancements in the cav- ernous sinus region by neurosurgeons at ANI, they are also able to treat the following dis- eases in this area: • meningiomas • invasive pituitary adenomas • chordomas • schwannomas • skull base malignancies • metastatic cancers • aneurysms • cavernous hemangiomas Learn more about surgical advancements in neurosurgery at chistvincent.com. n “An area of the brain that was once thought to be inoperable and risky is now operable and safe.”