In a first-of-its-kind procedure, clinicians at the University of Maryland Medical Center in Baltimore removed a rare spinal tumor through a patient’s eye socket.
The patient, Karla Flores of Rosedale, Md., had two slow-growing developmental bone tumors in her spine and wrapped around her brain stem, according to the University of Maryland Medical System. The tumors, called chordomas, are rare and diagnosed only about 300 times annually in the U.S., the system said in a May 5 news release.
In two procedures, surgeons removed the tumor around the brain stem with a traditional craniotomy — through the skull — and with an endoscope through her nose. A team of neurosurgeons, radiation oncologists, and skull base and facial plastic surgeons contributed to Ms. Flores’ care.
Mohamed Labib, MD, a neurosurgeon at the University of Maryland Medical Center, developed the novel surgical technique to approach the spinal tumor through a patient’s eye socket. The process involved cutting through a membrane protecting the eye and making an incision inside the patient’s mouth. A surgeon also removed the bottom of the eye socket and a portion of the cheek bone “to carve out a large enough pathway for surgeons to thread surgical tools into the sinus to reach the cervical spine,” the system release said.
After the tumor was removed, a facial plastic and reconstructive surgeon, Kalpesh Vakharia, MD, rebuilt the bottom of the eye socket with a titanium plate and rebuilt the cheek with bone from the patient’s hip.
Ms. Flores, now 20, was also treated with proton radiation therapy. To stabilize her spine, a neurosurgeon fused the C1 and C2 vertebrae in her neck. She currently has no evidence of cancer, according to the system.
