Dan Fabbio performed a piece on the saxophone during surgery to remove a brain tumour.

Saxophonist and music teacher Dan Fabbio played his saxophone during brain surgery, the University of Rochester’s Medical Centre reported. The performance was part of an effort to ensure that the removal of a tumour wouldn’t negatively impact Fabbio’s ability to play and hear music.

In 2015, the saxophonist, who was serving as a substitute music teacher in a school in New Hartford, New York, and studying for a Masters degree in music education, began to suffer visual and auditory hallucinations as well as dizziness and nausea.

“He had an MRI scan of his brain, which revealed a relatively large tumour in an area that is involved with sophisticated hearing and musical function,” said neurosurgeon Dr Webster Pilcher, who is the Ernest and Thelma Del Monte Distinguished Professor of Neuromedicine and Chair of Department of Neurosurgery at the University of Rochester. “When I met Dan for the first time, he expressed how concerned he was about losing his musical ability, because this frankly was the most important thing to him in his life, not only his livelihood, but his profession and his interest in life.”

“Removing a tumour from the brain can have significant consequences depending upon its location,” Pilcher explained. “Both the tumour itself and the operation to remove it can damage tissue and disrupt communication between different parts of the brain.”

Using highly sophisticated brain mapping techniques Pilcher developed with Dr Brad Mahon, from the university’s Department of Brain and Cognitive Sciences, and with the aid of Dr Elizabeth Marvin, who holds positions in both the University of Rochester’s Eastman School of Music and the Department of Brain and Cognitive Sciences, the team was able to produce a detailed map of Fabbio’s brain that specified both the location of the tumour and the areas vital to musical functions. The map was then used to guide the surgeons who removed the tumour.

The information on the map was confirmed during the operation itself, Marvin scoring Fabbio’s ability to complete humming and language tasks while mild electrical stimulus disrupted small areas of his brain.

Following the surgery, Fabbio’s saxophone was actually brought into the operating theatre. “The most assured way in the operating room to know that his music abilities were intact would be to actually have him playing his instrument,” said Mahon.

There was a degree of rehearsal required before the OR performance, as Fabbio would be lying on his side and there was a danger that the pressure caused by playing long notes could cause the brain – exposed during the surgery – to protrude from Fabbio’s skull. Fabbio and Marvin ultimately selected a Korean folk song, which could be played with short, shallow breaths.

“It made you want to cry,” said Marvin. “He played it flawlessly and when he finished the entire operating room erupted in applause.”

Fabbio went back to work just over a month after the surgery and, a year on, has suffered no ill effects to his musical ability.

The data from the procedure formed the basis of a study in the journal Current Biology, which has helped define more accurately the relation between the parts of the brain responsible for music and language processing. “Every time we do an operation we have an opportunity to learn something more about the brain,” Pilcher said, “and that information makes the operations we do all the more successful.”