Miracle operation by surgeons at Tulane Univ. Hospital removes
Richard A. Webster
Linda Pol noticed something wrong with her husband of 28 years shortly after they retired. The once energetic 59-year-old Thomas Pol did little but sit on the couch. After a few months he moved from the couch to the bed where he slept 23 hours a day.
I’d wake him up to eat and he’d just fall right back to sleep. He insisted there was nothing wrong, Linda said.
As Thomas listened to his wife tell the story, tears streamed down his face.
This woman, he said, barely able to get the words out, this woman was so persistent. She knew there was something wrong. She saved me.
Even Linda never imagined the deadly seriousness of the situation. For almost 15 years a benign tumor had been growing in the anterior lobe of Thomas’ brain just behind his eye sockets.
As it grew to nearly the size of a man’s fist, it crushed Thomas’ optic and pituitary nerves, compressed his brain stem and engulfed his carotid artery.
A CAT scan taken in Biloxi, Miss., revealed the monstrous growth but the attending doctor refused to touch it, Thomas said.
Because of its size and position in the brain, the tumor could only be removed through a highly specialized surgical procedure performed by only a handful of clinics in the country.
Two weeks after the initial CAT scan, Thomas Pol admitted himself Nov. 3 to Tulane University Hospital where Dr. Miguel Melgar, assistant professor of neurosurgery, and his team of surgeons took apart and reassembled Thomas’ skull during more than 23 hours of surgery.
This man had the worst of the worst, Melgar said. The tumor occupied one-sixth of the brain, the equivalent of an 80-pound tumor in the stomach. This was the first time a tumor of this magnitude has been removed using this technique.
Throughout the ’70s and ’80s the skull would be cut open in order to remove such a tumor. Surgeons then lifted the brain partially out of the skull using a hydraulic spatula. Results of such surgeries were poor, Melgar said. Patients who did not die during the surgery from swelling of the brain remained comatose for up to six months.
In the early ’90s, a new method called skull base neurosurgery provided more positive results. Instead of lifting the brain out of the skull, surgeons disassembled the skull to create a direct pathway to the tumor.
With this type of surgery the patient is able to wake up and talk like you or me because the brain has not been manipulated, said Melgar
At Tulane University Hospital, a skull base surgical procedure costs approximately $15,000.
Melgar, a leading expert in the field, founded a skull base center at the University of Texas in 1999. Last year he arrived at Tulane University Hospital with the intent of making it the foremost skull base neurosurgical facility in the country. Since his arrival he has performed almost 20 of these operations but none more difficult than the Pol situation, he said.
Before the Pols agreed to the surgery, Melgar told them the risks included blindness, paralysis or death. The Pols had little choice.
They told me I wouldn’t have lived another three months, Thomas Pol said. I would have gone to sleep one day and never woken up.
At 8 a.m. Nov. 3, Melgar sliced an incision just above Thomas’ forehead from one ear to the other. He then pulled the facial skin down below the nose exposing the eye sockets. Using a specialized electrical saw, he removed the bone above the eye sockets, took out the forehead in two pieces and carved out the nose bone between the eyes.
The eyeballs were hanging out of his head like a Halloween costume, Melgar said.
This created a passageway to the anterior base of the brain allowing Melgar to start removing the tumor. The process took nearly 24 hours with the surgeons breaking once for sleep.
After the surgery, Thomas said side effects included quadruple- vision, a lack of balance and weakened vocal chords. But given what was removed from his brain and how it was removed, he said the side effects are insignificant.
They literally tore my face off and took out my eyes and eye sockets, Thomas Pol said. To have that expertise and to really know how to use it is like having one of God’s gifts.
What most amazes Linda Pol is her husband had this tumor growing inside for so long without anyone ever detecting it.
How many other people out there have something like this and don’t even know it? Lind Pol asked. The problem is that many insurance companies refuse to pay for routine CAT scans. But this is something that should be done with physicals every five years or so. If somehow we caught this earlier it wouldn’t have been such a big deal.
Three days after the surgery, Thomas Pol suffered a massive heart attack. He is scheduled for double bypass surgery this month to unblock two main arteries. Doctors also found a new benign tumor around the nerves that control his hearing.
Melgar said Thomas Pol’s additional health problems are unfortunate but incomparable to the massive tumor once lodged in his brain.
The guy’s amazing, Melgar said. If he can come out of this as well as he did, he’ll make it through heart surgery with no problem.
Copyright 2004 Dolan Media Newswires
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