This story originally appeared in UCLA Today, a discontinued publication.

Surgeon restores a future pilot's dream

Photo by Reed Hutchinson UCLA Photographic Services
Neurosurgeon John Frazee (left) demonstrates to patient Paul Santos how an endoscope will be used to remove a cyst from his brain.

back on track

All his life, Paul Santos has dreamed of flying. During his childhood in Guam, he plastered his bedroom walls with posters of fighter planes. When he turned 18, he signed on with the Navy, with his eye on the sky.

John Frazee also dreamed of becoming a pilot. But his less-than-20/20 vision scuttled that plan, and he enrolled in medical school instead.

Santos, now 23, is stationed at Point Mugu Naval Air Station, where he serves as a radar operator, flying directly behind the pilot. He spent three months in Iraq on reconnaissance missions. Upon his return home, he enrolled in flight training at Embry-Riddle Aeronautical University, which has a branch at his air base.

And Frazee is now clinical professor of neurosurgery and director of UCLA’s Neuroendoscopy Program.

Last spring, the two men crossed paths when Santos found that a medical condition that first surfaced as a headache might ground him as a flier.

“I was having pain on the left side of my head,” the radar operator recalled. “I thought maybe it was a stress thing. Then I woke up one morning with a band of pain running across my head temple-to-temple.”

When his vision starting blurring, he headed to his Navy doctor and learned that an arachnoid — spiderlike — cyst was spreading a web across his brain behind his left eye. The doctor recommended a craniotomy, the standard procedure for removal of a cyst: A hole the size of a grapefruit would be bored into his skull, the cyst removed, the site covered with a metal plate — and Santos would never be able to fly again. “My heart just dropped,” he recalled. “But still, I never told myself I wasn’t going to fly.”

That’s when a friend referred him to Frazee, who specializes in endoscopic brain surgery. Using a tube-like device with a tiny camera guided by a light and incorporating miniscule surgical tools, endoscopy allows the entire procedure to be done through a small incision. And Frazee had developed a technologically advanced endoscope that is guided by a computer precisely to the surgical site, an approach similar to global positioning navigational systems in automobiles.

“Paul was a perfect candidate for this device,” said Frazee, noting that the cyst’s location could be easily reached with the endoscope. Although he had used it in actual surgery only five times, and never before on an arachnoid cyst, Frazee felt confident the surgery would be very successful. The procedure would require an incision the size of a dime, thus no metal plate would be needed, and recovery would be quick and complete.

Surgery took place on Sept. 1. “We are good to go, doc,” Santos told Frazee before rolling into the OR, giving the doctor a pilot’s thumbs-up. The procedure took only three hours, in contrast to a seven-to-nine-hour craniotomy. Two days later, Santos headed home, and he is already back at work, though on the ground for the time being. Follow-up visits show him recovering beautifully.

“I’ve told him he can hop on a plane again as soon as he wants to,” Frazee said. Santos’ Navy superiors are holding him back just a little longer until it’s clear he is 100% recovered.

“I can’t wait,” said Santos. “I’m a flyboy. I need to be up flying. To me, it’s the best job.”

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