The Hindu Business Line : They reconstructed the skull base

The medical experts were engaged in a 14-hour operation that involved micro-neurosurgery, skull base surgery, craniofacial surgery and a complete reconstructive plastic surgery.

Bangalore , July 21

IN a rare surgical feat that has raised hopes of panacea for cancer, neuro and plastic surgeons of Manipal Hospital here have removed massive skull base tumour.

The medical experts were engaged in a 14-hour operation that involved micro-neurosurgery, skull base surgery, craniofacial surgery and a complete reconstructive plastic surgery. Such a complicated surgery is undertaken by just a few hospitals across the world and Manipal Hospital became the first in the Indian sub-continent to achieve success.

Pratima Haldar from Kolkata was detected with a massive skull base undifferentiated malignant tumour. A fist size lesion involved the entire portion of her head, between the eyes starting from the roof of the mouth through the base of the skull and eroding into the brain. The tumour had also begun to grow out through the root of the nose under the skin.

She needed a regimen, which was a mix of advanced surgery to remove the tumour and followed by a treatment involving radiotherapy and chemotherapy. In Pratima's case, Dr Sujay Rao, Neuro Surgeon, Manipal Hospital, made an incision on the skull at the top of the head from one ear to another ear and the scalp was pulled down in front of the eyes. The main arteries feeding the tumour were identified in the neck and clipped in order to reduce haemorrhage from the tumour during the surgery. The bone of the forehead was widely opened and the tumour was found growing into the skull and through the cover of the brain. The brain was exposed and the tumour was micro-surgically removed including the rim of brain tissue along with the tumour. Dr Y.N. Anantheshwar, Plastic and Micro Reconstructive Surgeon, meanwhile, opened the face with an incision along the sides of the nose and down the lip. Taking away bone from the nose, upper jaw and in the area between the eyes he defined a large space in which the tumour was located. After the removal of the tumour, the surgeon found a huge cavity between the brain and the roof of the mouth.

In the past patients would often die because of sever infection cause by exposure of the brain to the outside and leakage of its fluid into the nose and mouth. However, with the help of the reconstructive surgery the surgeon reconstructed the skull base by taking the muscle from the side of the head and grafting into the skull base. A piece of bone was taken from the head and used to reconstruct the nose.

Dr Sujoy Rao and Dr Anantheswar have written off their fee and the hospital has subsidised cost of more than 1.5 lakh.

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They reconstructed the skull base