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Ground-breaking Surgery Removes Skull Base Tumors through Mouth

In a remarkable medical feat, a 67-year-old woman from Bangalore underwent a pioneering surgical procedure to successfully remove a tumour from her skull base through her mouth. Referred to as Mangala (name changed), the patient presented with a 2x2 cm tumour situated behind her upper jaw.

What sets this procedure apart is its innovative approach to accessing a challenging location—the parapharyngeal space, a narrow corridor extending from the upper neck to the skull base. Remarkably, the tumour was in close proximity (approximately 1.2 cm) to the internal carotid artery and multiple cranial nerves controlling essential functions such as tongue movement, voice, and shoulder function.

Traditionally, such surgeries would necessitate invasive methods such as splitting the lower jawbone or creating controlled fractures of the upper jawbone to gain access. Endoscopic removal posed challenges as it risked tumour spillage and a higher likelihood of recurrence due to removal in pieces. Similarly, conventional robotic surgery was unsuitable as it does not involve bone drilling, a requirement for access in this case.

To mitigate surgical trauma and aid recovery, the expert medical team at SPARSH Hospital adopted a groundbreaking approach—entirely through the mouth. They achieved access by removing the posterior aspect of the upper jawbone and displacing muscles to create a corridor for complete tumour removal.

Dr. Narayana Subramaniam, Director of Head & Neck Surgery, Oncology, and Clinical Innovation at SPARSH Hospital, expressed satisfaction with the surgery's success. He highlighted the novelty of the approach, emphasizing its ability to remove the tumour entirely without resorting to splitting the jawbones or facial incisions. Mangala experienced a smooth recovery, devoid of major cranial nerve weakness or intraoperative bleeding, commonly associated with conventional methods.

Dr. Subramaniam attributed the achievement to a patient-centric approach, extensive expertise, and collaborative teamwork, underscoring the significance of these elements in achieving excellent outcomes in complex head and neck surgery.

The two-and-a-half-hour procedure culminated in Mangala's smooth recovery, marking a significant milestone for SPARSH Hospital. This success underscores the institution's dedication to innovative and patient-centric care, showcasing its commitment to advancing healthcare through progressive solutions for patients grappling with complex medical challenges.

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