Endoscopic Brain Surgery: Saves Life of An Elderly Lady of HerYears of Ordeal – GG Hospital
Dr.Manoj Krishnan – ENT, Head, Neck & Skull Base SurgeonMBBS,DLO,DNB(ENT),FCNS(SkullbaseSurg)
What can be called as one of the most significant advancements in the field of Endoscopic Brain Surgeryin the last decade, GG Hospital offers the latest, multi-angled Endoscopes with Neuro-Navigation and Nerve-Monitoring that enable the surgical team to perform skull base surgeries with utmost efficiency and precision,led her to enjoy her life walking and talking with her loved ones without fear or pain.
85 yr old lady in her complete senses with intractable headache and facial pain was suffering froma disease called Trigeminal Neuralgia for many years sending her life into a world of pain and withdrawal. She was active and cheerful until this disease, also known as ‘suicide disease’ caught hold of her.
She was on medications for years but soon she developed a dreaded complication called Steven Johnson syndrome for the medications.
She underwent a Radio-Frequency (RF) treatment on her offending nerve thereafter which gave her relief for only few months.
She was later treated with Radiotherapy to the brain where the nerve exits and it provided relief for about a year or so.
Soon her symptoms returned with so much more force to the extent that even the sound of a fan triggered an excruciating facial pain and therefore she covered her half head with some clothes all the time suffering the heat of our hot climate.
Then her condition reached a stage that she could not bear the pain at all and she was forced to try her old medicines. And she got repeated attacks of Steven Johnson syndrome forcing her to spend many days in the hospital battling the painful blisters forming all over her body.
That’s when she heard about the renowned skull base surgeon Dr.Manoj Krishnan who has pioneered in very minimally invasive endoscopic operations for a wide variety of diseases affecting the cranial base where the brain rests.She decided to meet him and after hearing her story patiently he ordered few investigations including an MRI scan to determine the exact nature of her disease. The tests revealed a blood vessel in her brain is abnormally entwined on the nerve which takes the sensation from the face to the brain causing it to rub the nerve. That has resulted in inflammatory damage to the nerve causing it to send abnormal pain impulse to the brain. The radiation to the brain had further complicated the problem by thickening the delicate membrane of the brain called arachnoid mater.
Since she had used up all other options unsuccessfully she was left with only one choice – operation in the brain and remove the offending artery from the nerve. She was very scared and reluctant to undergo any surgery in the brain because of the possible complications it could bring especially in an octogenarian. But after discussing with Dr.Manoj Krishnan and consulting her grandson who is a doctor in the USA she decided to undergo the operation.
She also had concerns about the Anaesthesia which were dispelled by Dr. B.Radhakrishnan, the Head of the Department of Anaesthesia of GG Hospital&Dr.Vimal VV, Dr. Sivakumar R Pillai. We have a very expert team of anaesthesiologists who could match upto the challenges of such very minimally invasive skullbase procedures.
And finally the day came! Dr.Manoj Krishnan drilled a small hole@ 1cm in her skull bone and with 3mm endoscope dissected all the scarred membranes covering the brain and the nerves. Then he meticulously separated the highly convoluted artery rubbing the Trigeminal nerve and its roots from the brainstem all the way to its exit from the skull.
The offending convoluting artery over the Nerve in the brainstem seen from inside.
After placing a bio-inert cushioning wool implant the craniotomy was closed.She had no brain or anaesthesia complications.
After the surgery. The post operative ICU is managed by a very experienced and skilled Intensivist – Dr. Jithu….who observed very closely for any signs of complications and dealt with them promptly.
When she woke up she could not believe herself that her years of pain have disappeared completely, this time forever!! She walked out from GG Hospital in another couple of days.
Presently she enjoys her life walking and talking with her loved ones without fear or pain.