without opening the skull
For the first time, a Saudi medical team at King Fahd Hospital in Jeddah was able to perform a rare surgery in two hours for a twenty-year-old man without opening the skull, and to reach areas of fractures through the nose.
The head of the medical team, consultant nose and sinus surgery at the hospital, Dr. Mohamed Mahmoud Zahran, said that the young man suffered a traffic accident that resulted in multiple fractures at the bottom of the skull and face, which led to coma and paralysis of the left facial nerve and leakage of the surrounding fluid in the brain and spinal cord, known as Dura mother.
He pointed out that the necessary therapeutic procedures were taken by the therapeutic team to diagnose the location of brain fluid leakage, which was the result of a fracture in the wall of the upper pituitary nasal sinus, and surgical treatment plans were developed to treat the fracture and fluid leakage through the nose by reaching the fracture area at the bottom of the skull by Nose without the need to open the bones of the skull or brain tissue using optical endoscopes and modern techniques that include the use of an explorer.
Zahran added that the patient''s condition is stable, and that the presence of the fracture caused the brain fluid to leak into the pituitary nasal sinus and in turn the nose, which could have caused acute infections such as "fever or abscess in the brain tissue", and therefore it was necessary to treat the fracture area leading to the leakage Which was previously treated by opening the skull and raising brain tissue to reach the bottom of the skull and treat that leakage, but with technical development in the field of sinus and laparoscopic surgeries, sinus surgery doctors were able to reach deep or surrounding nose areas such as the eye, the pituitary gland, and the cavities inside the bottom of the skull , Through the nostrils without the need to make any incisions in the face or head and using optical endoscopes, and with the help of an explorer device that was provided at the Al-Masa''dia Specialist Center at King Fahd Hospital in Jeddah about a year ago.
Zahran reported that the leakage area was thinned using a patch of the patient''s thigh and placed in the roof of the nasal pituitary sinus after adjusting both sides of the fracture and then placed stents to fix the patch, and a tube was placed in the patient''s back to keep the surrounding fluid pressure in the brain low, which helps to keep the patch in place And that was in the first days of the recovery period, and the patient recovered from the hospital after checking on the safety of his health.
It is noteworthy that the medical team consists of each of the consultants of neurosurgery, Dr. Khaled Damyati, and anesthesia consultant, Dr. Ahmed Mustafa, and the specialist in otolaryngology, Dr. Liqa Natto, and supervisors of the technology of the explorer Abdel Rahman Al-Harthi and Nour Al-Ayesh.
