Yemeni man lives 14 years with bullet in skull, undergoes rare surgery in Bengaluru

Abdul (name changed on request), a 34-year-old Yemeni, said he lived for more than 14 years with a bullet embedded deep in his skull base—a stray shot that struck him while he was walking down the street, altering the course of his life and causing persistent pain.

“But there was nothing he could do because the facilities in war-torn Yemen were far below par. So, he learned to live with pain behind his right eye and frequent attacks of bloody nasal discharge," said his friend and caregiver, who accompanied Abdul to India to get the bullet removed, to PTI. Abdul could speak only Arabic.

Abdul’s final destination was Bengaluru. “A lot of our friends and acquaintances, who have already been here to undergo complicated medical procedures not available back home in Sanaa, recommended we come to Bengaluru," said the friend.

Here, at Aster Whitefield Hospital, through a scarless endoscopic nasal surgery—which the doctors said is a rare and high-risk procedure—the surgeons removed the bullet in a procedure that lasted nearly three hours.

Since the bullet was horizontally embedded under the optic nerve and close to the carotid artery—structures essential to vision and brain function—a combination of neurosurgeons and ENT specialists were part of the surgical team, said Dr Swaroop Gopal, Group Director–Aster International Institute of Neurosciences and Spine Care, who led the team.

The bullet’s location was the key challenge for the surgical team, said Gopal. It was deep within the skull base, invisible externally, and surrounded by critical neurovascular structures.

“The bullet’s position made both doing nothing and invasive surgery potentially risky," added Gopal.

Abdul’s friend recalled how every single day of his life Abdul suffered from severe nasal infections because of the deeply embedded bullet.

“He was really good at studies, but had to stop after his bachelor’s degree in Arabic because he couldn’t concentrate due to pain," the friend added.

“Since the bullet was so close to the optic nerve and large blood vessels, we had to choose a method that was safe but accurate," said Dr Jyotirmay S Hegde, HoD & Lead Consultant–ENT, Aster Whitefield Hospital, who was also part of the surgery team.

“The transnasal procedure gave us access to the skull base with no external incision. With the help of advanced cranial navigation and endoscopic visualisation, we were able to safely extract the bullet with unprecedented precision, subjecting the patient to minimal trauma and facilitating scarless recovery," Hegde added.

The doctors explained how they drilled through the bone and mucosal tissue slowly to access and retrieve the bullet without compromising adjacent structures.

The technique did not leave a single cut or scar on the face and protected the patient’s sight, they added.

When PTI spoke to Abdul, although he was recovering well and had been discharged two days after the surgery last month, he was still waiting in Bengaluru to return to Sanaa.

“We have been here close to 45 days now. We took advantage of the opened air space to get here. But since then, there have been air attacks in Yemen and the airspace is closed again," added the friend.

The immediate pain relief, said Abdul, is already a game-changer.

“Once we reach home, I have decided to enroll in a postgraduate course and continue my studies," said Abdul, who dreams of teaching Arabic professionally.

India