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+1 difficult case with the leading otolaryngologist of the clinic

+1 difficult case with the leading otolaryngologist of the clinic

Modern technologies in the hands of virtuoso doctors make it possible to solve extremely complex neurosurgical problems as if it were an ordinary ENT operation to straighten the nasal septum.

This is exactly the patient’s story shared by the leader of the otolaryngology department of the VIRTUS clinic, Dmitry Pilipyuk, who devoted most of his professional life to treating the most complex diseases of the ENT organs and adjacent areas. For example, through the nose he can operate on a cerebral hernia – meningoencephalocele.

In the photo you see an MRI image of the head of patient Dmitry Nikolaevich, who contacted VIRTUS with complaints of breathing problems. But the diagnosis showed a neoplasm. This is a so-called cerebral hernia, which is formed due to sagging of the membranes of the brain, and in some cases, the brain tissue itself.

As a rule, such problems manifest themselves as problems with nasal breathing, but more often they make themselves felt in the form of liquorrhea – the flow of fluid from the brain into the nose. And this is a problem, because everything that is in the skull must be hermetically protected from the environment.

Not only does liquorrhea create serious discomfort – something constantly drips from the nose, but there are prerequisites for the development of meningitis. Therefore, such openings should be closed. Before the era of endoscopy, this involved craniotomy, then it was necessary to go down, raise the frontal lobes, and only then carry out the necessary manipulation. It was not very practical and not very convenient.

The concept of modern surgery is to delicately approach the hole through the nasal cavity and literally fill in the brain tissue, after which plastic surgery of the defect is performed, for which the patient’s own tissue is used. Everything happens under the control of an endoscope, which guarantees delicate and precise movements of the surgeon. The benefits for the patient include minimal trauma and the absence of any external signs of surgery.

The result of the operation was the cessation of liquorrhea and the closure of the defect. Dmitry Pilipyuk also warned of an increase in hernia. Within three weeks after such manipulation, swelling remains, feeling like a runny nose. Little postoperative wound care is required. Drainage for alternative discharge of cerebrospinal fluid is not needed. After two days in the hospital, the patient went home.

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