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Nationally unique surgery performed at the Department of Otorhinolaryngology

14 January 2020

Nationally unique surgery performed at the Department of Otorhinolaryngology

Professor Imre Gerlinger, head of the Clinical Center Department of Otorhinolaryngology, and dr. Martin Chovanec, visiting professor from Prague performed a sensational surgery unique in the country at the Pécs clinic. During a joint operation, they removed an acoustic tumour from the cerebellopontine angle in a way that they rehabilitated the patient’s hearing with the remaining cochlear nerve and a cochlear implant.

 

Written by Rita Schweier

 

In April 2019, the visiting professor program was launched at our School to invite foreign teachers and researchers and start research and teaching collaborations with them at the Medical School and the Clinical Center. Professor Martin Chovanec became a visiting professor at our School from 1 November last year after having previously participated in pituitary surgeries twice.

As Professor Imre Gerlinger said, Professor Chovanec is an otorhinolaryngology specialist who has extensive experience in neurosurgery and works as an associate professor and head of department at the Department of Otorhinolaryngology and Head and Neck Surgery of the Charles University in Prague. He has acquired special skills in the management of pituitary paragangliomas, macular vertebral processes, and acoustic neuromas.

In their current collaboration, they removed a benign tumour of the internal auditory meatus, which, due to its location and beyond a certain size, can create a life-threatening condition by spreading to the cerebellopontine angle and thus pushing the brainstem. Because it is removed through the labyrinth, the patient's hearing must be sacrificed on the affected side. This is a rare type of cancer and it is difficult to gain experience for such a surgery in a country with a population of ten million people. Another difficulty is that the cochlear nerve is cut in many cases.

The intervention is sensational because it is the first case when the facial nerve and the cochlear nerve were preserved and, after the removal of the tumour, the middle-aged man's hearing has been rehabilitated with an inner ear implant inserted into the cochlea. During the seven-hour surgery, the internal auditory meatus was accessed together, which lasted for five hours, and then Professor Chovanec also assisted in the removal of the tumour.

According to Professor Imre Gerlinger, in their future collaboration they would like to further refine and make the translabyrinthine removal of acoustic neuromas a routine surgery, work together on paraganglioma surgeries, and, in the case of patients with the Meniere's disease – besides the preservation of the hearing – they are going to perform the vestibular neurectomy in a retrolabyrinthine way, which leads to the elimination of complaints of dizziness.

Professor Chovanec is going to visit Pécs every four months for two to three days to assist the specialists in Pécs in complicated interventions. Another plan is for resident students of Pécs and Prague to exchange experiences and spend some time at the clinic of the other party.