This week I did a most interesting case. It was interesting because it was a joint effort. There were 3 senior Consultant surgeons, each from a different speciality, each with different training and each with an assistant – so six surgeons in all! And all for one man who had a tumour behind his sinuses, literally in the middle of his head. Probably one of the most inaccessible areas in the whole human body. We got the tumour out in a five-hour operation and today he is able to eat, drink and even smile.

What’s so great about that, I hear you say?

PT Fossa Tumour

Side view PT Fossa tumour


Well, I’ll tell you why: His whole upper jaw was separated from the rest of his facial skeleton and dropped down by a maxillofacial surgeon (just imagine someone taking out their upper dentures). Next, a microscope was brought in and the back wall of the sinus was removed to expose the tumour lying behind it, about 3 inches deep to the cheek skin. After careful piecemeal removal (bear in mind the whole area was full of nerves and blood vessels) I handed over to a Neurosurgeon to check and see that I had cleared the tumour from the underneath of the skull-base and had not damaged the under-surface of the brain.

Anyway, the technical details are all a bit gruesome for most people’s taste, but the point of all of this is to illustrate what amazing things can be achieved when people from different walks of life co-operate with each other for a common goal. I could not have done this operation and cured this man without the skilled help and advice from my colleagues. I learn from them, and they learn from me. We all converse in medical-speak, understand each other, appreciate the issues each has to deal with and overcome. We thought this through over several weeks and spoke about the case a lot – until we had each rehearsed our own role in our heads over and over. There is no dress rehearsal. None of us had ever done a case like this before. So the first time was the one-and-only shot, and it had to be perfect. I would not take the credit for curing the man (who has a young wife and kids): it was a team effort. But it is good to know I can ask for help when I feel I need it and furthermore know that the help will be unflinching and totally committed. And that makes me feel very secure.

You’ll be amazed at what you can achieve if you get the right people around you and they share your idea.

Posted in: ENT

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