U.S. surgeons at the University of Maryland Medical Center (UMMC) have successfully removed a rare spinal tumor from a 19-year-old woman using a novel transorbital approach, which involved accessing the tumor through the patient’s eye socket. This marks the first time such a technique has been used for spinal tumor removal, offering a less invasive option for complex cases.
Karla Flores was diagnosed with a chordoma, a rare developmental bone tumor, when she was 19. The tumor had wrapped around her spinal cord and invaded the vertebrae in her neck, just below the base of the skull. The surgical team, led by neurosurgeon Dr. Mohamed Labib, developed a unique procedure to access the tumor through the patient’s eye socket, creating a ‘huge surgical corridor’ to reach the affected area without external scars.
The procedure required a multidisciplinary approach, with Dr. Kalpesh T. Vakharia, a facial plastic and reconstructive surgeon, carefully performing delicate surgery to remove the bottom of Flores’ eye socket and a portion of her cheekbone. Vakharia emphasized the importance of minimizing scarring and the need for a ‘surgical plan where there would be no external scars.’ The team also rebuilt the eye socket and cheek using a titanium plate and bone from the patient’s hip to ensure a full recovery.
Laboratory research and cadaver practice were crucial in planning this surgery. Dr. Labib noted that the opportunity to practice the transorbital technique on cadavers ‘many, many times’ was essential for the success of the operation. Additionally, Flores had a large tumor around her brain stem, which was removed through two separate procedures via her skull and nose, showcasing the complexity of her treatment.
Following surgery, Karla Flores also underwent radiation therapy to eliminate any remaining cancer cells. She has since made a remarkable recovery and is now preparing to return to work and school. Despite some nerve damage that has caused minor issues with her left eye, she remains optimistic about her future and her plans to pursue a career as a manicurist.
The team at UMMC is now preparing to demonstrate the transorbital procedure to neurosurgeons from around the world at their annual Skull Base surgery course. This technique has the potential to reduce tumor recurrence and improve outcomes for patients with similar conditions. Dr. Labib highlighted that this approach allows for a complete removal of the tumor, which significantly reduces the risk of cancer returning.