Music During Surgery

We all love music but just how powerful is it? I recently read an article about a music teacher who had music as a major part of his life. When he found that he had a tumor located in the part of his brain that was responsible for music function, he was devastated and intent on beginning a long journey involving a team of physicians, scientists and a music professor that culminated with him awake and playing the saxophone as the surgeons operated on his brain.

His particular case is now the subject of a study published in the journal Current Biology that gives some new light on how music is processed in the brain.
This 25-year-old man began to suddenly see and hear things that he knew were not real as he was serving as a substitute music teacher in a school in New Hartford, New York. He was in a small office at the school working on the project for his Master’s degree in music education when the symptoms began to appear.

The tumor appeared to be benign and had probably been slowly growing since childhood and was located in an area of the brain that was relatively easy for surgeons to access. But, it was located in a region that is known to be important for music function, which was his life. He was referred to UR Medicine’s Del Monte Institute for Neuroscience and neurosurgeon Web Pilcher, M.D., Ph.D.

Pilcher is the Ernest and Thelma Del Monte Distinguished Professor of Neuromedicine and Chair of Department of Neurosurgery that had struck up a partnership with Brad Mahon, Ph.D., an associate professor in the University of Rochester Department of Brain and Cognitive Sciences. They have together developed a Translational Brain Mapping program for patients who had to undergo surgery to remove tumors and control seizures.

The brain mapping program that they developed is tailored to the circumstances of the individual. Mahon and his team subject each individual to a battery of tests, including brain scans that identify important functions as motor control and language processing that may be located in proximity to the tumor and potentially impacted by the surgery.

Every brain is organized in more or less the same way but the location at a fine grain level of a given function can vary up to a couple of centimeters from one person to another.
Testing language and motor skills were relatively straightforward but in a trained musician, it was a completely different undertaking. There couldn’t have been a better fit for this patient’s case. They developed a sophisticated brain mapping program that would be key to the procedure’s success, but the famed Eastman School of Music that is a part of the University of Rochester could be called upon to help plan his surgery.

The patient was to lay on his side, so playing the instrument would be difficult as it was a saxophone. The pressure also caused by the deep breathes required to play long notes on the saxophone could cause the exposed brain to essentially protrude from his skull. A version of a Korean folk song was selected and modified to be played with shorter and shallower breaths. The music theorist would stand in the operating room land be a consultant to brain the surgeons.

They used the map of his brain to plan the surgery while he was awake and playing his saxophone. The patient has completely recovered and was returned to teaching music within a few months.

The brain mapping program’s main purpose is to help improve surgical outcomes but the information they gather before, during and after the surgery is also helping to advance understanding of complexities of the brain’s structures and function.

The data from this case is the basis of a study and has helped more precisely to define the relation between the different parts of the brain that are responsible for music and language processing. This reminds them of what an incredible outcome it had and also of just how far we have come.

Dr Fredda Branyon