Leading-Edge Techniques Uses Tiny Cameras for Greater Precision

Sandra Glattly, 78, has keen insight into the phrase, “being in the right place at the right time.” A resident of Atkinson, a small town in northwest Illinois, Glattly suffered a stroke in December 2008 while visiting her daughter-in-law in Lake Forest. Following an ambulance ride to a nearby hospital, she was transferred to NorthShore Evanston Hospital for its expertise as a Primary Stroke Center.

There, Glattly benefited from the NorthShore Neurological Institute (NNI), a multispecialty system of care where the most advanced technology and clinical integration are available to treat neurological conditions, including stroke. Evanston Hospital, along with Glenbrook and Highland Park Hospitals, earned the Gold Seal of Approval™ from The Joint Commission for Primary Stroke Centers, following national standards that can significantly improve outcomes for stroke patients.

During the course of her stroke treatment, an MRI and CT scan revealed a tumor in Glattly’s sinus cavity that was very close to her optic nerve and the base of her brain. “If I hadn’t had the stroke, they wouldn’t have found the mass in my sinuses,” said Glattly.

Joseph Raviv, MD, Director of the Sinus Program in the Division of Otolaryngology, Head and Neck Surgery at NorthShore, was consulted on Glattly’s case after the tests revealed the sinus mass. Dr. Raviv specializes in endoscopic sinus and skull-base surgery. Endoscopic surgery involves small cameras and surgical instruments that are inserted directly through the nostrils, avoiding the need for incisions on the face or scalp.

“In certain situations, endoscopic approaches to the skull base provide better visualization and more precision to remove tumors compared to external approaches,” said Dr. Raviv, who holds an academic appointment at the University of Chicago Pritzker School of Medicine. “We can angle the cameras and view around corners. It’s very three-dimensional.”

Not every case is amenable to an endoscopic approach, however. Physicians from specialties as diverse as neurosurgery, oncology and radiology consult as an interdisciplinary team to consider several factors, including the exact location and specific pathology of the tumor.

Techniques in endoscopic surgery, as well as skull-base surgery, have greatly advanced in recent years. NorthShore physicians are on the leading edge of these advancements, which are offered at only a limited number of Chicago area hospitals.

Dr. Raviv initially removed a small portion of the tumor for biopsy, which showed malignant, or cancerous, potential. Glattly’s case was then presented at NorthShore’s weekly Tumor Board, a “meeting of the minds” that includes physicians from surgery, oncology, radiation oncology and pathology. After this consultation, Dr. Raviv removed the remainder of Glattly’s tumor.

Glattly has fully recovered from her stroke. And although she admits she “moves a bit slower,” she volunteers at her local hospital and continues to enjoy trips with her husband to Lake Forest to visit her daughter-in-law and grandchildren. She also sees Dr. Raviv annually for checkups and MRIs, and her tumor has shown no sign of returning.

“Dr. Raviv’s bedside manner is amazing,” said Glattly. “Being away from home, I was fortunate to be in such a good hospital with such great care.”