A rare operation, the first of its kind in Israel, was recently performed at Soroka to remove a tumor from the brain of a deaf patient. According to the scientific literature, this is only the third time such a procedure has been performed in the world.
Tawfik Alatrash is a 40-year-old man with congenital deafness who was diagnosed with a brain tumor in his dominant hemisphere. Following clinical and neuroradiological assessment, the medical team advised Tawfik to undergo surgery to remove the tumor. Without surgery, the tumor might have continued to grow, affecting Tawfik's speech, motor, and cognitive functions.
Operations to remove brain tumors while the patient is awake are considered complex and challenging from a surgical perspective, mainly due to the proximity of these tumors to eloquent brain areas, which are involved in important functions such as language, motor movements, sensation, vision, and high-level cognition. To preserve these important brain structures, during the surgical intervention, the relevant functions must be closely monitored and evaluated based on continuous communication between the surgical team and the patient.
When this type of operation is performed on a congenitally deaf patient, full cooperation is required between the patient, a sign language interpreter, and the surgical team so the patient can answer questions and perform motor and cognitive tasks during surgery. This communication allows the surgical team to achieve maximal safe resection of the tumor while avoiding damage to vitally important brain areas.
Before the surgery, Tawfik underwent a comprehensive evaluation that included imaging and neuropsychological tests that assisted in the planning and preparation of the procedure. The operation was performed under local anesthesia to prevent pain or discomfort, and the presence of a multidisciplinary team and the full support of Lolita Mirson, the sign language interpreter, made it possible to closely monitor Tawfik's important brain functions during the resection. The surgery was led by Dr. Amit Azriel, a neurosurgeon who specializes in brain tumors. Dr. Azriel gained a great deal of knowledge and experience in this type of surgery during his neuro-oncology fellowship program in Australia and was joined by members of the multidisciplinary team at Soroka: a dedicated anesthesia team led by Dr. Ron Gal; Dr. Limor Gertner Sa'ad, senior neuropsychologist at Soroka; and dedicated nursing and neurophysiology teams.
Dr. Amit Azriel, senior physician at Soroka's Department of Neurosurgery: “This operation was extremely challenging due to the patient's congenital deafness, and it required the outstanding multidisciplinary cooperation of many different teams from the hospital departments and the assistance of Lolita, Tawfik's interpreter. It was important for us to ensure we carefully preserved the motor areas and the areas responsible for understanding language, all of which are important for Tawfik's full functioning. I am happy that the complex procedure was successful and that together we were able to remove the tumor in a way that will help Tawfik to continue functioning without new limitations."
The surgery was successful and Tawfik was discharged from the hospital within a few days.
