50 g Tumour Removed from An Engineer’s Right Ear at Wockhardt Hospital, Mira Road
Mumbai: A team headed by Dr Vinod Rambal, a Neurosurgeon in Wockhardt Hospital, Mira Road, Mumbai successfully performed a Retro Mastoid Craniotomy to remove 50 g of nerve tumour from a 27-year-old male engineer from NCR, diagnosed with Vestibular schwannoma causing total hearing loss and facial numbness and heaviness.
Mr Nishant Khanna (name changed)*, an engineer by profession and works at NCR encountered unexplained hearing loss for about 6 months. He panicked, was jolted out of his normal routine, and couldn’t focus on his work. Later, his right side of the face was numb and heavy. He consulted various medicos and medical management but nothing seemed to work in his favour. However, the patient came to Wockhardt Hospital, Mira Road, wherein he was promptly treated.
Dr Vinod Rambal, a Neurosurgeon, Wockhardt Hospital, Mira Road, said, “On his first consultation his brother had already developed a liaison and primary consultation with the neurosurgeon on an outpatient basis who lives in Mira road. MRI of the brain showed a skull-based tumor meaning that the tumor arises from the nerve that controls our balance and posture. This nerve is also in intimate contact with the nerve which controls our facial expressions and taste. Also, another nerve is meant to serve the purpose of the hearing. The nerves responsible are the 7th and 8th cranial nerves complex and are located at the back of the skull, somewhere near the ear and the base of the skull. His MRI showed a skull base tumour, meaning that the tumour arises from the nerve that controls our balance and posture. Sadly, this nerve also is in intimate contact with the nerve that controls our facial expressions and the other nerve which is responsible for hearing as well. The nerves responsible essentially are the 7th and 8th cranial nerve and the tumour is located at the back of the skull somewhere between the ear and the base of our head. Consistency of the tumor was at some places it was solid and there were multiple different sized fluid-filled sacs within the total tumor. It had intimate contact with vital parts of the brain and pushed the brain stem. The brain stem, midbrain, and pons are the vital connecting junction between the brain and the spinal cord through which to and fro brain activity happens. This part contains the super control of cranial nerves meaning their nuclear origin which is embedded in this location and long track fibers which travel up to the brain and down to the spinal cord."
Dr Rambal added, “It was confirmed that the patient had Vestibular schwannoma, a benign cranial nerve tumor arising from 8th cranial nerve around the back of one's ear and this is the exit for these said nerves and it grows initially it starts to grow from the nerve in the cave which has got other nerves as the bony cave expands not so much, it mushrooms into the soft area into the brain, the hindbrain called the cerebellum and part of the brain stem, Pons. The brain stem, midbrain, and pons are the vital connecting junction between the brain and the spinal cord through which to and fro brain activity happens. Around 2 per million is the incidence and usually seen in 50 and 60 age group. There is no definite reason for one to have such a benign tumour. The peculiar finding was mainly his young age and solid and multiloculated cystic components within the same tumor and that makes it technically challenging surgical removal. After counselling him and his family, he underwent the operation. The surgery lasted for 6 hours and was a task because of the position or rather the location of the tumour, the route through which the tumour was accessed, was from behind the ear. The consistency and its intimate contact with the critical parts of the brain are what made it very difficult to operate on. He was discharged after a week’s time, being fully functional. The facial numbness has disappeared and there seems to be only a partial loss in hearing but that too shall be in recovery and will be confirmed regarding the status after 6 months. His young age and good health helped him recover quickly.
“I was working from home during pandemic while one day there was a sudden hearing loss. I was unable to hear what my friend said on a call or what was going on the TV. I became anxious and consulted a doctor. I feared stepping out owing to pandemics. But, my hearing didn’t improve. I didn’t know what was happening to me. I wouldn’t carry out my daily activities with ease or concentrate on work due to hearing loss. To my dismay, I also noticed facial heaviness and numbness. By now, my health worsened. I immediately spoke to my brother who stayed at Mira Road, who fixed an appointment for me at Wockhardt Hospital. I travelled from Delhi reached Mumbai, got operated on for a tumour in the back of the ear. Now, I am back on track, and I can hear and facial numbness has gone. I thank the doctors at Wockhardt Hospital for saving me. I urge everyone to carefully monitor the abnormal changes in the body, and seek timely medical attention,” concluded the patient Nishant Khanna (name changed)*.
