At the end of July 2015 a patient A.D., 42 y/o has admitted to MC Erebouni diagnosed with: giant neurofibroma of head with extra and intracranial growth, disintegration of tissues, with skull defect and multifocal tumor growth.
Since 1986 the patient was operated 14 times. The last one - 3 years ago, however the disease progressed. After meticulous examination of the patient and consultations of various specialists, the decision was made to carry out radical surgery of an extensive tumor removal with single-stage reconstruction of soft- tissue defects of the head.
In 30.07.15 under general anesthesia, by three teams of surgeons under the leadership of the Head of Plastic Surgery and Microsurgery Department Dr. Armen Hovhannisyan, MD was carried out a unique surgery. The team of plastic surgeons started with radical removal of extracranial part of tumor and affected area of the scalp. Intracranial fragment of the tumor removed the team of neurosurgeons under the supervision of Head of Neurosurgery Department Prof. Mamikon Eghunyan, MD. Due to his professional work it was possible to exfoliate the tumor from the brain, without touching its functionally important structures. The third stage: for reconstruction of the extensive defect of tegmental tissues of the head sized 44 × 32 cm, vascularized fragment of a greater omentum proportionate to the skin defect was isolated by Prof. H.V. Sarukhanyan. After preparation the great vessels of the neck, omentum was anchored in the defect and revascularized by anastomosis “end to side”, with external carotid artery and jugular vein. Over the omentum the splited and meshed skin autograft was imposed.
The surgery lasted 11 hours. Post-operational period went smoothly. Engraftment of transplanted grafts is complete. The patient is undergoing rehabilitation.
At multi-organ character of such kind pathologies, the success of the surgery is predetermined by a coordinated teamwork of specialists.
