Doctors remove tumour to give UAE resident her vision back

Doctors at Canadian Specialist Hospital (CSH), one of UAE’s leading multi-specialty hospital, helped a blind Egyptian woman, a UAE resident, recover her eyesight within 1.5 hours of operation. More importantly this operation was done using a minimally invasive endoscopic surgery through the nose and without removing the skull bone and exposing the brain. The patient was diagnosed with pituitary tumour and referred by an ophthalmologist because she started losing her eyesight. The pituitary gland is a pea sized organ in the endocrine system found at the base of the skull, above the sphenoid sinus and is essential for controlling hormone levels all over the body.

Using the unique four hands minimally invasive surgery technique and the teamwork of surgeons, the patient underwent the operation and has now completely regained her vision.

Dr. Mohammad Nooruldeen Jabbar, Specialist Neurosurgeon, Canadian Specialist Hospital, “Mariam (name changed), a 48-year-old Egyptian woman, sought medical advice after starting to lose her vision. The condition started with prolactinoma (pituitary tumour secreting prolactin hormone) a condition where milky substance is discharged from the nipple, which is completely unrelated to milk production”.

Her laboratory tests confirmed that she had high prolactin level and was treated accordingly. At first Mariam responded well to the medicine but after a while she started to complain of severe headaches, visual problems and cold chills. Eventually she lost vision in her left eye.

An MRI scan confirmed the presence of a huge pituitary gland tumour, also called a pituitary adenoma. It was fortunately benign and posed no threat to spread to other parts of the body. The adenoma was compressing the optic nerve coming from her left eye, and couldn’t carry the signals from the left eye to the brain causing gradual loss of her vision.

“The treatment of pituitary adenomas depends on the type of the tumour, its size, its extent and patient related factors. For this particular case, we consulted with our ENT specialist and decided to operate and remove the adenoma through an endoscopic endonasal surgery.  

Dr. Haitham Morsi, Specialist Otorhinolaryngology and Skull-base Surgery, Canadian Specialist Hospital, “Craniotomy is a high-risk surgery compared to the endoscopic transnasal pituitary surgery, where a piece of the skull bone is removed to expose the brain and then replaced after the surgery. After craniotomy there is scarring, chance of loss of sensation of smell, taste, seizure, behavioural changes, longer recovery period and high blood and cerebrospinal fluid loss. Endoscopic removal of pituitary adenoma is also less likely to cause post-operative hypopituitarism and provides a shorter hospital stay”.

Dr. Morsi further stated that, “In this case we used an endoscope to access the pituitary gland via the nose through the sphenoid sinus using an HD camera and with the aid of microsurgical instruments. With highly skilled proficiency and teamwork we were able to fully remove the tumour entirely with 50 ml blood loss and under 2 hours.”

Mariam regained her vision on the same day after compression on the left optic nerve was removed.  She was declared healthy and fit for discharge within a couple of days postoperatively. On her follow up consultations, she has shown no signs of any side effects or recurrence of the tumour.