Turned away by hospitals, 11-year-old saved his eyes with support of GITAM doctors

HYDERABAD: In an intricate surgery, doctors at GITAM Dental College, Visakhapatnam, carried out a medical miracle with seamless precision that saved a child from disfigurement and loss of vision.

Doctors from the Department of Oral and Maxillofacial Surgery at the GITAM Dental College and Hospital in Visakhapatnam successfully removed a lesion from the oral cavity of an 11-year-old child who had been turned down by multiple hospitals due to the risks involved in the challenging three-hour surgery.

A team of expert doctors at GITAM Dental College and Hospital successfully removed the lesion, which has a high tendency to bleed while operating. The removal was possible through an intricate procedure that saved the adolescent from having a permanent scar on the face.

Notably, the head and neck regions account for 25 to 45 percent of benign tumors of the nervous system called schwannomas. But, in the sinus and nasal region (like in this case), maxillary sinus is very rare, being found in only 4 percent of cases globally, with only eight cases being reported globally as of 2018.

There was a thin membrane separating the lesion from the lower part of the patient’s eye. Not only was the surgery costly, but it was also difficult to attempt. The possibility of accidentally fracturing the patient’s upper jaw during the procedure had to be taken into account, as well as the likelihood of loss of vision or bleeding into the eye. The post-operative care, too, was not likely to be a simple affair.

However, the doctors at GITAM Dental College approached the case with confidence. Dr. Satya Bhushan, the Head of the Department of Oral and Maxillofacial Surgery, said, "Our unit has a unique speciality that deals with such tumors of the face originating from teeth and other facial structures. Such specialists are few in number, and their availability is limited in private practice. GITAM Dental College, however, has had this well-established department for the past 22 years."

The team of operating doctors involved Dr. Satya Bhushan and Dr. U. Siva Kalyan, as well as post-graduate students Dr. Sindhuja, Dr. Kalyan, Dr. Raghu Ram and Dr. Harshini. The availability of state-of-the-art infrastructure at the GITAM Institute of Medical Sciences and Research (GIMSR) also helps doctors deploy advanced clinical approaches and techniques.

"We have opted for an intra-oral procedure, which is a cosmetic approach to removing the lesion from inside the mouth, rather than an extra-oral procedure, which would leave a scar on the face. Although it is difficult to get access through the intraoral approach, this decision was taken keeping the age of the patient in mind," Dr. Siva Kalyan said.

The initial diagnosis of the lesion was done through a procedure called Fine Needle Aspiration Cytology (FNAC) which identified the Central Giant Cell Granuloma (lesion). After the surgical excision of the lesion by the team of doctors at the GITAM Dental College, the pathological and microscopic examination of the growth of tissue showed that it was a schwannoma, a rare tumour of the nervous system.

Post-surgery, the patient was briefly admitted to the ICU. The young boy was fit for discharge just four days after the procedure was carried out. His recovery has been smooth.