In a world-first, surgeons performed a groundbreaking 19-hour procedure to remove a life-threatening spinal tumor from 19-year-old Karla Flores by accessing it through her eye socket. The tumor was located at the critical craniovertebral junction, where the brain meets the spinal cord, an area so precarious that traditional surgery would have been life-threatening. Lead neurosurgeon, Dr. Mohamed A. M. Labib, pioneered an entirely new surgical route—dubbed the "third nostril"—to reach the tumor without any major external incisions.
A Life-Threatening Challenge
Karla Flores was diagnosed with a chordoma, a rare and aggressive type of cancerous tumor that grows within the bones of the skull and spine. Her tumor was situated in one of the most dangerous and difficult-to-reach locations in the human body: the point where the skull and neck connect.
A conventional surgical approach would have required large incisions through the neck or the back of the head, involving the retraction of the brain and spinal cord. This would have posed an enormous risk of paralysis, stroke, or even death. Faced with this challenge, Dr. Labib and his team at the Barrow Neurological Institute developed an innovative, minimally invasive strategy.
The "Third Nostril": A Revolutionary Approach
The pioneering technique, formally known as the endoscopic transorbital approach, involved creating a novel pathway to the tumor directly through the face. This avoided any disruption to the brain and spinal cord.
The surgical team meticulously executed the following steps:
Accessing the Pathway: Surgeons made a small, hidden incision in the crease of Karla's eyelid.
Navigating the Orbit: They skillfully removed portions of her cheekbone and eye socket bone, carefully moving her eyeball to the side to create a clear channel.
Reaching the Tumor: This "third nostril" corridor allowed the surgeons to pass their instruments through the facial bones and gain direct access to the tumor at the top of the spine.
Tumor Removal: Over many hours, the team painstakingly resected the entire tumor through this narrow passage.
Reconstruction and Recovery
Once the tumor was successfully removed, the intricate process of reconstruction began. The surgical team rebuilt Karla's facial structure using custom titanium plates and a piece of bone grafted from her hip. This ensured the stability and cosmetic integrity of her face.
This groundbreaking method not only saved Karla's life but also left her with no visible scarring, preserving her appearance. Now cancer-free, Karla's case is being hailed as a landmark achievement in modern neurosurgery. This innovative procedure has the potential to revolutionize future treatments for deep-seated brain and spinal tumors, offering a safer and less invasive option for patients with conditions once considered inoperable.
