63-year-old Pakistani National, Mr. Abdul Hameed Baloch had lost hope as he suffered from a right sided hearing loss and an inability to walk due to an imbalance which caused him to sway to the ride side. He was referred to Dr. Sharath Kumar Maila, an Indian, Specialist Neurosurgeon at Medeor Hospital Dubai well renowned for his expertise and experience at operating brain and spine tumors.
His diagnosis revealed the patient had a tumor called Acoustic Neurinoma of about 3.5 to 4 cm’s size. Though the tumor was benign, it was large and caused pressure on vital brain structures called ‘Brain stem’ and also very important ‘Cranial nerves’ in the brain.
He advised the patient required an immediate surgical procedure called Retromastoid craniotomy to remove his tumor. Dr. Sharath utilized an ultramodern neurosurgical technology called “Intraoperative Neuro Monitoring” which helps to identity important brain structures during surgery. This technology also helps reduce the rate of any complications to a minimum using expertise and safe surgical practices.
The 5 hours surgery was successful and the tumor was completely removed. There were no post-operative complications such as facial and body paralysis, injury to the vital brain structures, loss of eye sight or difficulty in swallowing and eating food. Only 2-3% cases of death have known to occur post - surgery. The patient was able to walk again and discharged on the 5th post-operative day. The surgery and the advanced medical procedure, not only offered a new lease of life to the patient, but also ensured that he could now perform regular day-to-day activities with ease.
Mr. Abdul Hameed Baloch said, “I am very thankful to Dr. Sharath and Medeor Hospital Dubai for giving me new life again. At first I didn’t have a normal life and now I feel fresh and started walking again without any support.”
Dr. Sharath said, “This 3.5 large vestibular tumor was densely adherent to vital brain structures. It was completely excised by utilizing ultramodern technologies in Neurosurgery including Intraoperative Neuromonitoring. More importantly there were no new postoperative neurological deficits. Technology in right hands helps to achieve a good outcome for patients that require such challenging surgeries. Though costly it is worth using it to improve the safety of the patients.”
He added, “Intraoperative Neuromonitoring technology is widely prevalent in the western world and is not much utilized here in the region. It has to be employed in all the surgeries where ever it is required. Complete removal of Acoustic Neurinomas tumor is one of the most difficult Neurosurgical procedures and is possible only with well experienced neurosurgeons who can utilize appropriate gear. It is more about preserving the normal function after surgery than removing the tumor itself. A total removal of tumor completely heals the patient and doesn’t require Radiotherapy also following surgery.”
The Intraoperative Neuromonitoring technology helps the neurosurgeon to identify very important structures in brain and helps to differentiate lesions from normal brain, making the surgical procedure safe. In the current procedure it helped to identify vital structures like Brain stem, Facial and Lower cranial nerves and helped to preserve their function without causing any neurological deficit post operatively. In the yester years, there was no intraoperative neuromonitoring and the incidence of facial nerve palsy was very high at 30% to 40% following the surgery for Acoustic Neurinomas. With the inclusion of Intraoperative Neuromonitoring the incidence of Facial nerve injury and Facial palsy has been decreased to less than 10 percent. This also helps in increasing the extent of tumor resection in critical areas of the brain.
Dr. Sharath concluded, “Precaution can’t be employed for these, as it is a tumor. But one can be vigilant of the symptoms and any changes they observe and consult a doctor appropriately for early diagnosis and treatment.”