"the bottom of the skull"
The skull base endoscopic surgery team at King Khalid University Hospital of King Saud University Medical City has been able to perform several pioneering surgeries in the Kingdom. The team, which includes consultant neurosurgeon Dr. Abd Al-Razzaq Al-Ajlan, and consultant endoscopic nasal and sinus surgery, Dr. Saad Abdul-Razzaq Al-Saleh, performed a skull base graft surgery in the anterior cervical vertical contact area, after the patient''s problem began as a result of an operation to remove the adenoids behind the nose, which caused complications for the patient. It led to leakage of cerebrospinal fluid from the aforementioned area with meningitis. To treat this problem, this operation was performed through the nose laparoscopically without any external wounds. This operation is considered the first of its kind in the Kingdom and the first of its kind for an adult patient in the world.
As for the second operation, the meningioma was removed from the frontal clinical prominence of the sphenoid bone in the brain through the nose endoscopy, where the tumor was pressing on the left optic nerve. The tumor was removed and the visual strength of the affected eye was preserved, and this operation is also the first of its kind in the Kingdom.
The third operation was for a Sudanese patient suffering from a leakage of cerebrospinal fluid through the nose due to a prominent meningeal cyst from a hole in the sphenoid bone, and the operation was performed through the nose laparoscopically and is also considered one of the rare operations in the world. And the fourth operation is to decompress the optic nerve resulting from the meningioma in the anterior base of the skull through the nose endoscopy, and an elderly patient who is unable to bear the entire tumor excision process has undergone part of the strength of vision in one eye and preserving it in the other eye.
In continuation of the previous operations that have been accomplished, two operations have been performed to remove skin bags from the brain of two women through the nose laparoscopically, and it is considered one of the first operations in the Kingdom. All of the aforementioned operations were successful.
And Dr. Al-Ajlan emphasized that this precise type of operation is an important achievement for the surgery of the base of the skull and tumors of the nervous system in the region. He explained that this is an initial step for a long-term plan to establish an integrated system that enables the citizen and resident in Saudi Arabia to obtain the correct treatment, which is in line with the rapid development in the treatment of tumors in a way that competes with developed countries.
Dr. Al-Saleh stated that these operations are usually performed through an external wound and an opening in the skull bone, and "however, scientific and technical progress and global training have enabled us to perform these operations through the nose and sinuses with endoscopes without external wounds." He explained that recent studies have shown that the results of the operations of the base of the skull through the nose with binoculars are comparable to or better than that of an external wound in the success rates and with fewer complications in most
