Operation of cerebellopontine angle
In Atlas General Hospital we recently received a patient with serious problems that was caused by the tumor on the brain. After an examination that was done by dr Milenko Savić, it was established that the patient had large tumor in cerebellopontine angle on the left side (cranial vault). This tumor caused complete hearing loss. According to radiological characteristics tumor is benign. To patient this tumor with years is increasing in size, and currently it can be seen pressure on vital structures in back cranial vault, and especially on brain stem. Because this growth of the tumor for such a short period of time the patient would have serious neurological problems that would be life threatening.
The only way to remove this big tumor, or to reduce the pressure on important parts of the brain, to prevent the appearance of serious neurological disorders was a surgical intervention – the opening of the skull and the removal of the tumor.
How much brain surgery is complex?
It is very serious intervention that requires:
- Specific equipment for opening of the skull, access to the tumor itself and tumor removal
- Specific anesthetics without myorelaxants
- Use of apparatus for intraoperative monitoring of important brain functions and recognition of very important nerve structures in the surgical zone, and above all of the cranial nerves
- Specific post operational monitoring
In this patient, it was particularly important to preserve the function of the VII cranial nerve responsible for the facial movements, lid and tongue muscles (the so-called facial nerve). This can only be achieved by using a specific equipment, so-called intraoperative monitoring. Intra-operative monitoring allows certain nerves to be identified during the operation, and in this particular case a facial nerve.
This kind of apparatus currently is in use only in Atlas General Hospital and Clinical Center of Serbia
The operation lasted for 6 hours and it was finished without any introperative complications. We succeeded, in spite of such a large tumor and changed anatomical relations, to identify facial nerve and to preserve, and in the same time to remove tumor completely.
Immediately after operation the patient was awake and conscious, without any neurological damage.
The day after the patient is verticalized and it has started an independent walk, says dr Milenko Savić.
The surgery was performed by a surgical team who consisted of a surgeon, anesthesiologist, anesthesiologist, a neurophysiologist, an intraoperative monitoring engineer, two instrumental nurses, two nurses and it was led by Dr. Milenko Savić, neurosurgeon.
Short video of the operation:
