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Monday, May 12, 2008

Government Rajaji Hospital doctors perform a rare surgery

Mass removed from an infant

Done with no loss of blood

No damage to tear gland or face

MADURAI: A team of doctors successfully removed a polyp (mass), by performing a functional endoscopic sinus surgery with no loss of blood, on a 23-day-old baby boy at the Government Rajaji Hospital here on Thursday.

The 90-minute surgery is termed “rare and risky” as it had to be performed on a newborn. The infant was born to Ramesh Kannan of Dindigul and Devi at Sholavandan GH with a congenital birth defect of bleeding ‘Haemangiomatous’ polyp.

The baby was transferred to the sick neonatal unit of the GRH from where it was referred to the Department of Otolaryngology by P. Amutha Rajeswari, of neonatal ward.

A team of surgeons led by K.R. Jyothikumar, Professor and Head, Department of Otolaryngology, and comprising assistant professors P. Rajasekaran, J. Azhaguvadivel and T. Sivasubramanian, and anaesthesiologists A. Raja Manoharan, Professor and Head, Department of Anaesthesiology, S.C. Ganesh Prabhu, and M. Kalyanasundaram, Assistant Professors, swung into action.

A biopsy of the polyp was done to find out if it was ‘angio fibroma’ (angio fibroma is a vascular (blood vessel) tumour which might lead to erosion of the surrounding bone and, if left untreated, the disease could cause facial deformity, proptosis (eye-bulging) or blindness).

Considering the age and nature of the patient, struggling to breathe with blocked upper airway, doctors decided to remove the polyp through endoscopic excision.

According to Dr. Raja Manoharan, administering anaesthesia to the baby with blocked upper airway was a risky proposition. However, the anaesthesiologists successfully managed the respiration of the child.

“In conventional surgical procedure, the nasal wall will be incised to remove polyp in which the risk of ‘lacrimal duct’ (tear duct) getting damaged is higher. Besides, the loss of blood will be more and the patient has to live with a permanent scar on face. But this procedure does not cause any damage to tear gland or face,” said Dr. Rajasekaran.

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