In a first in north India, endoscopic skull base surgeons Dr Dhandapani S.S. and Dr Rijuneeta from PGIMER, Chandigarh, have performed total removal of complex planum meningioma, adherent to neurovascular structures through the nose in two patients using 4K endoscope system. A 48-year-old male and a 46-year-old female were referred to PGIMER, Chandigarh, with complaints of decreased vision. Their MRI revealed planum meningioma of size 3 cm at the base of the skull, abutting critical vascular structures such as anterior cerebral and internal carotid arteries on both sides, as well as neural structures such as both optic nerves and pituitary stalk. These tumours are usually operated on through open surgery, and the remaining part is treated with radiation.
Over the last few years, simple tumours are being removed through the nose endoscopically by neurosurgeons teaming with ENT surgeons. However, endoscopic removal through the nose is highly challenging in complex meningiomas close to neurovascular structures.
Dr Dhandapani’s team has previously also achieved many feats in endoscopy, including the first in the world to totally remove craniopharyngioma through the nose in a 16-month toddler.