Doctors explain why man was asked to play a saxophone throughout his nine-hour brain surgery

Saxophone music was heard emanating from an operating theater at Rome's Paideia International Hospital recently while a critical brain surgery was taking place. You would think the sound was a speaker, but that was not the case. The music source was the patient, playing the instrument on the operating table while a team of surgeons worked to remove a tumor from his brain, reported The Washington Post. The patient was awake for the entire nine-hour procedure. The 35-year-old patient, a saxophonist, had to play because his performance was required for the team to navigate his brain and avoid harming the areas he needed to continue playing the instrument, according to Christian Brogna, a neurosurgeon who oversaw the procedure.

“Each person is unique because each brain’s unique,” Brogna said, stating that as a doctor, the patient’s “wishes” and lifestyle are important aspects to consider while tailoring a successful surgery. It is common for patients to remain conscious throughout brain surgery. The aid of local anesthetics enables surgeons to map their patients' brains and avoid the regions that control speech, memory, and other crucial everyday activities. Some patients may read or respond to inquiries. In more recent years, individuals have even been recorded on video singing opera songs and playing the guitar and violin while undergoing surgery.

A musician's hand-eye coordination, motor abilities, and even math are all integrated into playing a musical instrument, according to Brogna, who said he conducts about 50 awake procedures per year. He claimed that the saxophonist's tumor was situated in difficult-to-operate-on areas that control movement in the body. Being left-handed made this patient's operation particularly challenging. It was more challenging to map his brain because it wasn't built like a right-handed person's, according to Brogna. The surgery was a success, with the man going home to his wife and children safely, Brogna shared.

The Italian national hymn and the "Love Story" theme were played during certain parts of the procedure by the man, who Brogna could only identify by the initials G.Z. Before the procedure, his team meticulously analyzed those songs, he claimed, because any incorrect note, irregular rhythm, or sudden halt could indicate that the surgeon was probing a region that should be avoided. According to Brogna, the patient wanted to share with media outlets that having a brain tumor removed was "not necessarily a negative experience." He was relaxed and trusted Brogna and his staff at all times. 

In addition to helping with the man's surgery, he added that the saxophone playing advanced his knowledge of the human brain and will be useful for future procedures. “Each surgery of this kind is a window into the complexity of the brain, and we learn from all these surgeries continuously,” he said, adding, “This was the saxophone now, but it can be anything important for the patient.”

The intervention, which lasted more than nine hours, made use of a multidisciplinary team made up of more than 10 professionals from all over the world including neurosurgeons, dedicated anesthesiologists, neuropsychologists, neurophysiologists, and engineers, supported by cutting-edge technologies such as neuronavigation. with tractography, ultrasound aspirator, intraoperative ultrasound, continuous neuromonitoring. A specific tracer was also used for cancer cells which made them more easily distinguishable from surrounding healthy tissue. "The intervention was really complex and required a long preparation and very high technology. It was one of the first of its kind performed in Italy in a private facility. Paideia International Hospital is equipped not only with the technology needed, but also with a 100 square meter operating room, and we also had the opportunity to organize a tailor-made team for this intervention, calling the best international professionals," a post on Paideia Hospital's website reads.