UAE: Doctors perform complex double surgery to save 70-year-old from facial paralysis

Doctors at Al Ain’s Tawam Hospital performed a two-step complex head and neck surgery to remove a tumour from a 70-year-old patient with skin cancer. They used neuro-monitoring to ensure facial nerve integrity.

The patient with basal cell carcinoma, a type of skin cancer that often develops on areas of skin exposed to the sun, such as the face, hails from Eritrea. People residing in countries with higher-than-average annual sunshine, such as the UAE and Africa, are at an increased risk of skin cancer. In fact, skin cancer represents one of the most common male malignancies in the UAE, with a prevalence rate of 14.5 per cent.

Neuro-monitoring is often used in complex surgeries, involving the nervous system, to assess the integrity of vital functions. The primary goal is to alert the surgeon and anaesthesiologist to impending injury to allow modifications in time to prevent permanent damage. It is sometimes used to map areas of the nervous system to guide procedural management.

The complex and unique procedure involved two surgeries – first, 14-hour-long surgery to remove the tumour and repair the defect with a forearm flap. The second stage operation was a parotidectomy (removal of the parotid glands and major salivary glands) using nerve monitoring and simultaneous bilateral neck dissection and removal of the peri-auricular tumour.

Dr Muwaffaq Al Ani, oral maxillofacial consultant, Tawam Hospital, at Abu Dhabi Health Services Company (Seha), said the patient had basal cell carcinoma, which had spread extensively through his face.

“The complete resection surgery was particularly unique and complicated owing to the proximity of the tumour to his eye, brain, and facial nerve. Therefore, neuromonitoring played a critical role in this surgery's success to ensure that we maintain the integrity of the facial nerve and prevent facial paralysis.

"The multidisciplinary team at Tawam Hospital has extensive experience in managing complex head and neck cancer cases, providing resection and reconstruction followed by rehabilitation. We are extremely proud of the team’s commitment, sacrifice, and efforts towards achieving positive patient outcomes.”

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