Advanced micro neurosurgery to the rescue

Kovai Medical Center and Hospital, Coimbatore presents case studies where advancements in neurosurgery helped relieve patients suffering from defective vision due to optic nerve compression

With recent development of advanced technology in the field of neurosurgery, challenges in the management of defective vision due to optic nerve compression can be easily overcomed to cure the disease.

Two such case studies are given below:

Case Study 1

A 35-year old female from Ethiopia contracted a rare disease known as Idiopathic Intra cranial Hypertension with worsening vision. As its name suggests, its cause is usually obscure and difficult to diagnose. The management of the disease is also complex. She faced difficulties in getting the problem treated properly in Ethiopia, however good destiny brought her to Kovai Medical Center and Hospital, Coimbatore, one of the largest superspeciality hospitals in India. She started treatment under Dr JKBC Parthiban, Senior Consultant Neurosurgeon. After evaluation, it came to light that both optic nerves need to be decompressed from the increased cerebro spinal fluid pressure that had built in her brain over a period of time. Through a unique surgical procedure that cut open the orbit’s lateral wall, the sheath covering the optic nerves were incised and the cerebrospinal fluid was let out in both sides in a single operative sitting. The procedure is called lateral orbitotomy and optic sheath fenestration. The headache that affected the patient disappeared in the immediate post-operative period and patient could see better with both eyes at the time of discharge. This surgery is challenging since it was carried out on both eyes at the same time. Microsurgical techniques and soft tissue handling are the cardinal rules for safe surgery and better outcome.

Case study 2

Another case is that of a 70-year old male from Ethiopia, who also suffered from worsening vision combined with psychiatric disturbance as his disease was a tumour of the pituitary gland, the master gland of the human body. He was symptomatic since nine months, and was evaluated and diagnosed with giant pituitary adenoma. He was operated at Ethiopia through the nostrils but with no significant recovery. He came to Kovai Medical Center and Hospital, Coimbatore, India for treatment and under Dr Parthiban, was re-evaluated, wherein it was found that he had a huge tumor causing compression of optic apparatus. He underwent craniotomy and tumour excision with special focus on optic apparatus decompression. As expected, his vision improved and his psychiatric disturbance also lessened.

Kovai Medical Center and Hospital, Coimbatore is now a teaching centre for neurosurgery in India and has advanced technologies in the Department of Neurosurgery. The latest Pentero 900 microscope helps in excising the brain tumours to near total with its fluroscent dye technology by illuminating the tumour cells. Micro neurosurgery is essential in dealing with such extremely challenging cases.