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>> Back in April, our son's having bleeding nose
and he didn't say much because he thought
it was something very simple.
>> Javier, hey how are you.
>> Hey, it's good to see you.
>> I was taking a photography class.
I was working in the darkroom.
I was working with a lot of chemicals,
so I thought maybe one of the fumes I've been breathing in
caused some sort of nosebleed.
>> This is the one before surgery and this is
the tumor here.
>> The tumor originated inside my sinus cavity
and then it actually started growing inwards
towards my brain.
>> And this is the tumor and as you come up more
in the nasopharynx, this is the part that--
The pathology returned as a juvenile
nasopharyngeal angiofibroma which is a tumor
that occurs typically in young men.
It is on the rarer side of tumors
but it is a common tumor that we see at Hopkins.
This tumor was unique insofar as it involved
a significant portion of the skull base.
>> The tumor was very ugly.
The tumor was entrenched inside my nasal cavity
and my brain and it eroded a lot of the bone,
was actually surrounding a optic nerve.
>> Tumors such as Javier's, when they involve
the skull base, are typically done
through a transfacial or an open approach,
which is done through the face.
Over the past several years, we've been developing
endonasal, minimally invasive approaches
to skull base tumors.
I have studied Javier's high-resolution imaging studies
in detail and felt that this case was most appropriate
for an endonasal approach, removing the tumor
through his nose as opposed to a transfacial resection,
working through an open incision in his face.
>> This approach is pretty new and he was telling me
that he recommends it because there's not
a lot of long-term side effects.
>> There is no incision in the face or in the mouth
and the recovery is significantly less with a nasal approach
as opposed to an open approach.
>> Ma, ma, ma. >> Oooh, grandma.
>> My recovery was very speedy,
like after I got out of surgery,
that was for a whole day in the critical care unit
and by the end of the night I was walking.
>> The surgery that they did was unbelievable.
They removed the tumor through the nose
without leaving him any scars
but the best part is not leaving the scars in our hearts,
that we've been treating as a human beings
with the warm touch, the professionalism,
and we thank Hopkins very much.
>> Javier's prognosis is excellent.
He had a complete resection at surgery
and he had no perioperative complications whatsoever.
I think medicine, particularly in neurosurgery
is different than it was 50 years ago.
Patients are very knowledgeable today
and I think it's very important,
that it's part of our job to actually explain
in a way that's understandable disease processes,
treatment options, and the risks and benefits
that go along with that and sort of help the patient
through that process so that at the end of the day,
we're both very happy with the decision we made.
>> When the doctors came out of that operating room
and I look at their faces, it was the feeling
that my son was back again and it was a much relief.
Yeah, I'm crying, can't help this.
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>> They are real. (chuckles)
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