Doctors at Fortis Vasant Kunj remove tennis-ball-sized facial nerve schwannoma from 39-year-old Kenyan woman
New Delhi: Doctors at Fortis Vasant Kunj successfully treated a 39-year-old Kenyan woman suffering from facial nerve schwannoma - an extremely rare tumour which grows on the Facial Nerve eventually causing - facial weakness, headaches, hearing and visual loss.
The team of doctors led by Dr Anurag Gupta, Senior Consultant, Neurosurgery along with Dr Yogesh Jain, ENT and skull base Surgeon performed this rare and challenging surgery, to completely excise the tumor - which lasted for 15 hours. The patient was discharged after 12 days in a stable condition with no neurological deficits.
Upon admission at Fortis Vasant Kunj, the woman was in a conscious state, irritable, had no vision in both eyes along with complete facial paralysis on the right side with hearing loss. She revealed that she had complaints of facial weakness, headaches along with hearing loss and visual loss for the past 3 years. She was evaluated with MRI brain and CT angiography brain, which revealed facial nerve schwannoma - a large tumour measuring 64.2 x 49.5 x 41.5 mm (size of a tennis ball) located in an intricate position which eventually caused facial palsy.
Based on the diagnosis, she first underwent a Ventriculoperitoneal shunt surgery - surgery to treat excess cerebrospinal fluid in the ventricles of the brain and to reduce the intracranial tension. Post the surgery, she became less irritable and also regained some perception to light in both her eyes. She was then planned for excision of the tumour. Taking into consideration the risk factors and avoid any damage to the adjoining intricate areas in and around the brain, the large size and extent of the tumour, a complex skull base approach was planned.
Giving details of the case, Dr Anurag Gupta, Senior Consultant, Neurosurgery, Fortis Hospital Vasant Kunj said, “The woman had come to us from Kenya, as there she was advised a 2-step surgery each lasting around 20 -22 hours, with low chances of survival. We drilled the bone of her skull as skull base approaches like this allow access to large tumours of the brain without any pressure on brain which can be harmful to the brain.
The skull base bone drilling and preparation took nearly 4 hours before we started removing the benign tumor. Had she been not treated on time, she would have developed weakness in her hands and legs, difficulty in swallowing and eventually death due to increased pressure on the brain. At present, she is conscious, alert, walking on her own, has started seeing some light in the eyes and is eating and talking normally. The surgery had associated risk factors, if delayed or in case unsuccessful - risk of death, permanent paralysis or vegetative state.”
Facial nerve schwannomas are rare slow-growing tumours, accounting for less than 1% of all temporal bone tumours. Schwannoma grows on the seventh cranial nerve of the facial nerve. It is a benign tumor that grows slowly. It has afflicted less than 200,000 people worldwide and affects 1 in 50,000 people in India, according to cancer.gov.
Dr Gurvinder Kaur, Facility Director, Fortis Hospital Vasant Kunj said, “It was an extremely rare case and timely surgery was very critical. Despite being a life-threatening case, the doctors at Fortis Vasant Kunj under the leadership of Dr. Anurag Gupta could successfully perform the surgery. We will continue to do our best for our patients and ensure they receive the highest quality of medical care and attention.”
