Posted 10 апреля, 09:42
Published 10 апреля, 09:42
Modified 10 апреля, 10:11
Updated 10 апреля, 10:11
A team of doctors from the FEFU MC was able to return the patient the opportunity to breathe, eat, talk and live fully, using all the capacities of the medical center,
The reason was the myxoma, which in two years had swollen to a size comparable to a baby's head. The giant tumor stretched all the tissues, blocked the tongue and displaced the trachea, squeezing the blood vessels supplying the brain. Only a quarter of the jaw and a tiny gap in the throat remained. Against this background, the patient began to have breathing problems, for the last year she no longer spoke and practically stopped eating, having lost up to 40 kilograms.
– We went to the central clinics of the country several times and waited for the quota for the operation in Moscow, – said the patient's mother Elena Yuryevna. – But after studying our case, the doctors recommended contacting a multidisciplinary clinic. So we got to the FEFU medical center to maxillofacial surgeon Valery Tolmachev.
Sophia was taken with great apprehension. The unclear nature of the tumor, the high probability of the neoplasm growing into the walls of the vessels with their compression, serious exhaustion, as well as the patient's burdened anamnesis, made the prognosis extremely unfavorable. Physiologically, the girl could not endure prolonged anesthesia and a lot of blood loss. She underwent a number of additional examinations, CT, MRI and simultaneously performed two vital surgical procedures. During the preparatory stage, the girl was attended by a team of six surgeons of various specialties, endoscopists, anesthesiologists-resuscitators and a whole staff of nurses.
There was no free space in the operating room: an anesthesiologist, 6 surgeons, an endoscopist, residents and nurses started a complex operation. First of all, the doctors restored the girl's breathing by installing a tracheostomy tube. The next step, surgeons under the control of an endoscope created an artificial entrance into the stomach cavity and placed a feeding probe (gastrostomy). After a month of serious drug therapy and a specially selected diet, the necessary five kilograms were gained. The girl was ready for the main stage – removal of the tumor.
– In the professional life of a doctor, patients with such advanced diseases are extremely rare. You can't do such a miracle alone, only a multidisciplinary team has a chance. We have such a team – Ruslan Totorkulov, Deputy Chief Physician for Surgical Care of the FEFU MC, neurosurgeon, commented on this case.
The second fear was for the language. Due to the lack of a retaining muscle group, the root of the tongue could fall into the throat and block the airways. And the third danger is the communication of the oral cavity with the skin. Additional fabrics could be required to close the defect. However, in the process it turned out that the tumor did not destroy them, but simply compressed and displaced them. A huge plus was the results of morphological examination – the malignant process was not confirmed, the tumor turned out to be benign.
– I lost track of time while we were trying to separate her. At some point, after a complete microsurgical mobilization of the tumor, I pressed from the side of the oral cavity, and it moved away, completely unchanged tissues, a healthy tongue and the entrance to the oropharynx appeared behind it. That's when I felt a huge relief, – described his condition maxillofacial surgeon MC FEFU, MD Valery Tolmachev.
After the removal of the tumor, Sophia began to recover quickly. Despite the concomitant diseases, the patient had a tracheostomy removed and was discharged home a week later. There is no threat to life anymore, the dynamics are positive: Sofia speaks well and clearly, her weight has increased to 50 kilograms. A year later, a young woman will have bone grafting using microsurgical techniques to restore the jaw in a highly specialized clinic.
For surgeons of the FEFU Medical Center, this is not the first experience of communicating with serious patients. The clinic provides high-tech care, performs diagnostics and rehabilitation of patients based on advanced technologies in the field of medicine and specializes in the multidisciplinary treatment of complex cases with burdened anamnesis, such as where regional medicine is unable to help.