Dubai – MENA Herald: Canadian Specialist Hospital, one of the leading private sector hospitals in the UAE, has become one of the few centres in the region to have successfully performed the bimanual technique of endoscopic skull base surgery, one of the most intricate yet minimally invasive procedures to remove skull base tumours.

Surgeons at the hospital put in a team effort to remove pituitary tumours from a 40-year old patient whose vision was impaired due to the tumour pressing on the optic nerve. The patient has since left the hospital with significantly improved vision and no post-surgery complications.

“Prior to the procedure the patient underwent thorough eye check-up and endocrinology consultation to see if the tumours are secreting any specific hormones, in addition to ENT, neuro surgeon and anesthesia consultation as well as CT and MRI investigations,” said Dr. Saied Al Habash, ENT Specialist – Endoscopic Sinus & Skull Base Surgeon.

The pituitary gland is a pea-sized endocrine gland attached to the base of the brain. Most pituitary tumours are benign (non-cancerous) adenomas, but some of them may secrete hormones and hence require a different treatment approach.  The larger, non-secretory tumours are the ones that cause changes in eyesight when they press on the optic nerve.  

The treatment is to surgically remove as much of the tumour as possible using an endoscope passed up the nose and through the sphenoid sinus (endoscopic transphenoidal resection). The procedure leaves no external scar and any tumour left behind is treated with external radiotherapy.

“Endoscopic skull base surgery is considered the next step after endoscopic sinus surgery, used for surgical treatment of chronic sinus problems. Technical developments now enable surgeons to navigate the endoscope across the skull base, from frontal to the cervical and from one eye to the other,” explained Dr. Saied.

The bimanual technique further improves the navigational advantage in an endoscopic skull base surgery. In this technique the ENT surgeon and neurosurgeon work together to give better exposure and more ability to remove the tumour. The ENT surgeon begins the procedure, opens surgical entrance and directs the endoscope to help the neurosurgeon.

“The surgeon can use one hand to hold the endoscope and the other for dissection. In this way it’s easier to reach most of the deeper intracranial lesions with high precision and efficiency. Team spirit and co-operation makes the difference and sometimes the help of an eye surgeon or neuro radiologist is also sought,” said Dr. Saied.

Dr. Saied added that the bimanual technique is a major milestone in the increasing application of endoscopy as a minimally invasive surgical procedure. “It’s the era of endoscopy. You cannot imagine where the endoscope can reach in the sinus and the brain, and how much the endoscope lessens the complications, morbidity and mortality associated with these organs!”

The endoscopic endonasal approach is being widely used in skull base tumours and other cases like cerebrospinal fluid leak and intracranial lesions. “At Canadian Specialist Hospital, we are trying to be the leaders in endoscopic skull base surgery in the private sector as we have a very co-operative and expert team of ENT specialists, neurosurgeons and ICU doctors backed by all the required facilities for these kind of advanced surgeries,” added Dr. Saied.

Canadian Specialist Hospital provides a wide range of medical services and houses some of the most advanced surgical facilities in Dubai. Continuous development and investment in technology, medical expertise and support facilities have contributed to the hospital’s current stature as one of the preeminent medical institutions in the Middle East.