A senior citizen from Bengaluru has successfully undergone a complex procedure for the removal of a tumour from her skull base through the mouth at a private hospital in the city.
What made the procedure unique was the location of the tumour, said doctors at SPARSH Hospital, where the 67-year-old woman presented with a 2x2 cm tumour behind her upper jaw.
“It was behind the upper jaw in the parapharyngeal space, a narrow corridor that extends from the upper neck to the skull base. It was in proximity (around 1.2 cm) from the internal carotid artery, the main artery that supplies blood to the brain, as well as multiple cranial nerves that control tongue movement, voice and shoulder function,” doctors said.
Conventional approaches would involve splitting the lower jawbone or creating a controlled fracture of the upper jawbone to move it out of the way for access. The concern with endoscopic removal was that it would require removal in pieces and not whole, leading to spillage and a higher chance of recurrence. Robotic surgery was also not considered as conventional robotic surgery does not involve drilling away of bone, which was required to provide access in this case.
To reduce the trauma associated with surgery and recovery, a team of doctors from the hospital used a novel method, where the entire approach was through the mouth, and the access was by removing the posterior aspect of the upper jaw bone and displacing the muscles to create a corridor to completely remove the tumour.
Elaborating on the procedure, Narayana Subramaniam, Director - Head and Neck Surgery, Oncology and Director - Clinical Innovation at the hospital said, “This was a unique approach for an unusual tumour. By devising this approach, we were able to access this tumour and remove it completely without splitting the upper or lower jaw and avoiding any incisions on the face.”
