Mangaluru: A 15-year-old boy from Kasaragod district in Kerala has successfully undergone complex skull-base surgery at AJ Hospital & Research Centre, Mangaluru, for juvenile nasopharyngeal angiofibroma (JNA), a rare and highly vascular tumour.The procedure was led by Dr Ajay Kumar, consultant surgical oncologist and robotic surgeon, with support from Dr Deepalakshmi, consultant ENT surgeon; Dr Sanath Bhandary, consultant plastic surgeon; and teams from anaesthesia and critical care.JNA is a benign but locally aggressive tumour that primarily affects adolescent boys. Although non-cancerous, it can grow extensively and cause serious complications because of its high vascularity and proximity to vital structures. In this case, the tumour was located at the skull base, close to the internal carotid artery at the carotid siphon and the optic nerve at the orbital apex. The location posed significant risks, including severe bleeding, stroke and loss of vision, doctors explained.A multidisciplinary team was formed to plan and perform the surgery. The doctors carried out a modified maxillary swing procedure, a technically demanding approach that provides wide access to the skull base. Through meticulous microsurgical dissection, the tumour was separated from the carotid artery and optic nerve, while preserving the patient’s vision and neurological functions.“This case highlights an important principle of modern oncology — complex surgical care is never the effort of a single individual,” Dr Ajay Kumar said.The patient’s mother thanked the medical team for explaining the procedure clearly and supporting the family throughout the treatment. The patient is recovering well, with his vision and neurological functions preserved.Dr Prashanth Marla K, medical director, urologist, certified robotic surgeon and transplant surgeon at AJ Hospital & Research Centre, said the case demonstrated the importance of advanced surgical planning and coordinated multidisciplinary care in managing complex conditions.
