By Our Staff Reporter
Dehradun, 2 Jun: An extremely challenging and difficult surgery was done at Shri Mahant Indiresh Hospital by a team of doctors of the Ear Nose Throat and Cardio Thoracic Vascular Surgery departments. This surgery was performed on a patient named Gulshan (22), a resident of Roorkee, who had a rare vascular neck tumour (carotid body tumour) for the last 3 years. The neck swelling was progressively increasing in size due to which the patient had been experiencing pain and recurrent attacks of dizziness.
She consulted many hospitals and private clinics but due to the complex nature of surgery and high risk involved she was denied surgery. However, the doctors of SMI hospital took up the challenge and the patient underwent surgery performed jointly by a team of ENT surgeons headed by Professor and HOD Dr Tripti Mamgain and Dr Arvind Makker, senior Professor of CTVS department. The surgery lasted 12 hours.
Dr Tripti Mamgain reported that although they have operated upon carotid body tumors in the past but this was the most challenging case classified as Carotid body Shamblin type IIIB tumor in medical literature. This tumor was completely engulfing a part of the common carotid and internal and external carotid arteries (the main vessels supplying the brain, head and neck). Along with this, the Vagus nerve (responsible for breathing) and hypoglossal nerve (responsible for tongue movements) were embedded in the tumor. The main challenge was to resect the common carotid and internal carotid artery and reconstruct it with the graft and preserve these nerves. The risk involved was torrential hemorrhage fatal for the patient’s life and development of hemiplegia and paralysis of nerves making the patient handicapped for life.
Before surgery, tumor embolisation was done by intervention radiologist Dr Prashant Sharda. Her entire tumor was removed and carotid reconstruction was done taking a great saphenous vein graft from the patient’s leg. All the nerves were saved.
Post surgery Gulshan has recovered well. She is fine without any cranial nerve deficits and has normal limb movements. The entire cost of surgery was covered under the Atal Ayushman Yojna.
The surgical team comprised Dr Tripti Mamgain, Dr Arvind Makker, Dr Sharad Hernot, Dr Kanika Arora and anesthesia team of Dr Rubina Makker and Dr Priya Sachwan.