Breaking Boundaries: Endoscopic Nasal Approach to Skull Base Surgery

Ahmad Hussain, a 29-year-old patient from Iraq, had been grappling with nasal stuffiness and left eye protrusion. Battling left Naso-maxillary Ewing’s Sarcoma, he had undergone Trans-Nasal Endoscopic Surgery eight months ago, followed by post-op radiation therapy for Sino-nasal Ewing’s Sarcoma.

But despite the surgery and post-op treatment he continued having nasal stuffiness and slight left eye protrusion. He then decided to get a second opinion.

He was fortunate to find himself under the capable supervision of Dr. Harnarayan Singh, Director & Head of Department of Neurosurgery at SHALBY Sanar International Hospitals, Gurugram. After thorough evaluation and crucial investigations, it was revealed that Hussain had mild non-pulsatile Proptosis in the left eye and a blocked left nasal airway, indicative of a residual left Naso-Maxillary tumour (Ewing’s Sarcoma).

Understanding the urgency, Hussain was briefed about the necessity of surgery to remove the tumour as safely as possible. During the operation, the doctors discovered the tumour not only filling the left nasal cavity but also protruding into the right nasal cavity. He was administered general anaesthesia and underwent an endo-nasal endoscopy, aiming for a near total excision of the tumour.

Medical treatments can be complex and nerve-wracking, especially when faced with conditions like Ewing’s Sarcoma. However, finding the right surgeon, who displays empathy as well as expertise, can be life-changing. In this case, the young Iraqi patient underwent skull base surgery utilising an endoscopic nasal approach to resolve his challenging medical condition.

Thankfully, the patient’s post-operative recovery went smoothly. He was closely monitored in the ward and showed steady vitals, ultimately being discharged in a stable condition.

Dr. Harnarayan Singh, Director & Head of Department of Neurosurgery at SHALBY Sanar International Hospitals who performed the surgery, highlighted the hospital's dedication to patient care, stressing the meticulousness of the procedures and the rarity of Ewing’s Sarcoma. He remarked, "This Skull Base surgery was performed trans-nasally, ensuring minimal invasiveness, with zero cuts. With a multi-disciplinary approach, we ensured the best outcome for the patient in a relatively short hospital stay."