'endonasal surgery'

Trigeminal neuralgia or 'Tic Doloreaux' also infamously called as suicide disease, is a disorder affecting the Trigeminal nerve as it exits the brainstem.The disease is many times erroneously attributed to dental pain and many patients undergo multiple dental extractions before they are diagnosed correctly. Trigeminal Neuralgia can be treated by medicines and not all patients may require surgery at the outset. The problem starts only when more doses of the drugs are needed and patients are unable to tolerate the adverse effects of drugs , is surgery advised. The surgery involves placing a small teflon pledget under the offended nerve so that it is not compressed by the blood vessel. This offers almost immediate, complete and long lasting relief where the patients are completely free of medications and more importantly pain.

Trauma or injury to the skull or spinal cord occurs most commonly due to vehicular accidents. Other reasons for injuries remain fall from height, fall of heavy object over the body or any cause we attribute as accidental. The injuries to brain and spine can be minor , major or critical which will necessitate urgent intervention. Surgery for such Brain injuries is required only under special circumstances like open fractures, blood clots or large swelling of the brain lobe. Surgery is spinal injuries is required if there is fracture , dislocation or imminent threat to limb function. The neurosurgeon is best trained to determine the need for such surgeries and also timing them so as to minimise damage and ensure recovery.

Brain tumors are now increasingly diagnosed due to the easy accessibility of CT scan and MRI scans. There are different types of tumors found affecting the brain. Broadly they are benign (non-cancerous) and malignant (cancerous). All the types of tumors can be effectively dealt with if diagnosed in the early stage. The location, size and the proximity to critical areas in the brain decide about the outcomes of an operation. The surgery for Brain tumors has become safe due to improvements in anaesthesia, Imaging techniques, Intra-operative neuro-monitoring and tools like CUSA. Patients do feel very little pain or discomfort & hospital stay is a short.

Pituitary Tumors - Surgery for tumors arising from the pituitary gland . the pituitary gland lies at the base of the brain in a small bony impression called as the sella. The pituitary gland is responsible for the overall control of hormones regulating the various bodily functions ( thyroid, adrenals, gonads-ovaries & testes). Tumors arising from the pituitary gland can present with hormonal disturbances, eyesight problems (reduction in visual field)and other non-specific problems like headaches or giddiness. All these problems can arise slowly or may manifest suddenly due to bleeding inside the pituitary gland( pituitary apoplexy). Surgery is needed for tumors which are not responsive to medications or if the tumor is causing pressure on the optic nerves giving rise to visual problems. Surgery for pituitary adenomas is most commonly performed through the nostril with an endoscope or microscope. Patients need hospital stay for 4-5 days approximately. close monitoring of hormones is required in the post operative period.

Surgery for problems arising in brain or Spine in children ( below 18 years). several common problems like hydrocephalus ( accumulation of excess fluid in brain), tumors, spinal problems ( tethered cord- part of spine remains tethered )

Surgery for problems arisng from diseases affecting the blood vessels of the brain. common problems are bleeding secondary to aneurysmal hemorrage, infarcts caused by narrowed neck vessels, Moya moya disease.

Surgery of spinal disorders like degenerative disorders, spinal tumors, spinal trauma and congenital spinal problems. Common spinal problems lead to pain in the neck, lower back or pain radiating in hand or leg. spinal problems may also result in walking difficulty by causing gait disturbances, leg cramps and tingling sensations or numbness.