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BOSTON — The surgeon had already maneuvered into the patient’s nose like a caver. The journey had begun with bristles of moustache magnified on two different screens, each hair pitch-black and alarmingly large. Then came the great opening chamber, with blood vessels running red along the sides like ancient etchings. But he soon arrived at a spot that seemed impassable — little more than a crack between pink walls of flesh.

“That’s where the brain lives,” said Dr. Benjamin Bleier, as he poked his metal tool into the folds of nasal lining.

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Two or three times a month, at Massachusetts Eye and Ear, Bleier uses that same passage to drill and flake his way through patients’ skulls. These days, he’s doing those skull base surgeries with neurosurgeons to remove tumors. But he’s hoping that soon he can use them to solve another problem: the difficulty of getting certain drug molecules into the brain.

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