Nasal route
A breakthrough which could revolutionise the practice of neurosurgery has been achieved. Now certain life-threatening tumour lodged deep inside the brain can be accessed through nasal endoscopy. The technique was improvised by Vijay Sheel Kumar and his team at the Indraprastha Apollo Hospital, Delhi.
The tumour is accessed through the pathway of nose using an endoscopy-based technique. The procedure is virtually bloodless and has greatly reduced fatalities among the patients, said Kumar, who was presenting a paper at an international meet on skull base in Delhi. The new technique enables a surgeon to reach parts of brains like sella and pituitary glands, which are relatively difficult to access through conventional surgery. The patients also do not have to suffer from post-operative trauma, and can be discharged within two or three days of the surgery. More importantly, the treatment costs less when compared to the conventional surgery.
The research on the technique began in the West about three years ago. Now, it is successfully being used to treat tumours of pituitary gland, leakage of fluid from brain and carrying out biopsy of clivus and the skull base. In this technique, the brain is reached through the natural pathways of facial cyanoses. In case of pituitary tumours, the tumour is treated endoscopically through nose. This ensures that there is no blood loss. Crucial to the technique is a four-millimetre-long lighted endoscopy by which the tumour is reached. The removal of the tumour is done by using very fine delicate instruments that are introduced adjacent to the endoscope and the real time images are displayed on a colour television monitor.