Surgeons Remove Benign Tumor From Infant's Nostril Caused by Brain Leaking Into Nose

Rare condition resulted from incomplete separation between cranial cavity and sinuses.

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Surgeons conducted a very unusual operation on a baby last week at Meir Hospital in Kfar Sava. They removed a benign tumor from the left nostril of a four-month-old baby. The unusual growth was caused by his brain leaking into his nose.

This is a very rare occurrence, which happens when the separation between the bottom of the cranial cavity and the sinuses does not form properly during pregnancy. As a result, parts of the connective brain tissue penetrate the sinuses and nose before it closes, and such a growth is known as a glioma.

“This growth exists in the literature but it is very rare to find it in reality,” said Dr. Yaniv Avner, a pediatric ear, nose and throat specialist at Meir Hospital, who has treated the infant since his birth and carried out the operation.

“During pregnancy there is a natural opening between the brain and nose. As the pregnancy advances, this opening closes and the brain tissue disappears and retreats back into the brain region. These are connective tissues that are in practice support tissue or a sort of ‘scaffolding’ of the brain envelope,” he added.

In very rare cases, such as in this case, there is a break in the process of closure of the nose and it takes place only later. During this period the brain tissue leaked into the nose and was trapped there.

Even though it was impossible to see anything exceptional externally after the birth, the baby’s mother said he immediately began to suffer from breathing difficulties. At first the doctors thought some amniotic fluid had remained or the baby had a deviated septum. But as time passed the tumor in his left nostril grew and began to press on the right nostril too, and the breathing problems worsened. “Babies up to six months old depend mostly on breathing through the nose,” explained Avner.

That is, the tumor’s growth required its removal. First it was necessary to conduct an MRI to determine whether the tumor was still connected to the brain tissue, but luckily the opening to the brain had closed completely and the operation could proceed.

A month before the operation the tumor grew significantly and interfered with the baby’s breathing, so much so that his parents feared he would choke to death while he was sleeping. The endoscopic surgery was done slowly, using optical fibers and miniature cameras, and in the end the growth was removed from the roof of the nose, said Avner. This opened the baby’s airway.

The night after the operation was the first time the infant breathed properly, said his mother.