Rohit Shishodia  
Doctors at Wockhardt Hospital have given a new lease of life to a 72-year-old patient by performing a complicated brain tumor surgery.

The patient, Dhansukhlal Dedhia, who also suffers from prostate cancer, developed progressive vision loss. It was revealed that the patient was diagnosed with a 4 cm pituitary adenoma pressing on his optic nerve causing blindness.

He was discharged on September 18, 2020, with no complications. Dedhia, a resident of Mumbai, developed prostate cancer earlier this year for which he underwent Transurethral resection of the prostate (TURP) in May 2020, and was on chemotherapy and steroids.

A few months ago, he started encountering vision problems, which took a toll on his active life. The patient was dependent on his family members for carrying out his daily chores.

Dr. Mazda Turel, Neurosurgeon, Wockhardt Hospital, said, “On September 8, 2020, the patient presented with the history of bilateral blurred vision for the last few months. His vision deteriorated over days and he was unable to see things beyond a foot. The MRI showed a 4cm tumor pressing against the optic nerves causing visual loss.”

The oncologist decided that prostate cancer was under control and it would be worth going ahead with surgery to restore vision.

Dr. Turel added, “The patient was scheduled to undergo endoscopic endonasal tumor resection. His Covid test, done a day prior to surgery, was negative. The patient underwent Endoscopic transnasal trans-sphenoidal radical excision of pituitary macroadenoma under general anesthesia on September 9, 2020.

An endoscope with light and camera was inserted in one nostril and advanced to the back of the nasal cavity. A small portion of the nasal septum that divides the left and right nostril is removed. At the back wall of the sphenoid sinus, there is the bone overlying the pituitary gland known as the sella. This was removed to expose the tough lining of the skull called the dura.

The dura was opened to expose the tumor and pituitary gland and the tumor was extracted. Tumor removal corrected the vision problems and restored normal hormone balance. The patient had also developed transient hyponatremia, which was corrected.

Dr. Turel explained, “We removed the tumor completely relieving the pressure from his optic nerves.  He made a good recovery and was back to reading the newspaper within 4 days of surgery. He was discharged with near-normal vision.”

The doctor further said, “This surgery is particularly challenging in times of Covid given that the nasal passage is a harbinger of infection and operating through the nose and drilling the base of the skull generates aerosols.”