Overview

• The innovative 'third nostril' technique involved accessing a spinal chordoma via the eye socket, avoiding traditional high-risk approaches.
• The 19-hour surgery required millimeter-scale precision to shift the eyeball safely and remove the tumor near critical neurovascular structures.
• Extensive preoperative rehearsals on cadaver heads ensured the procedure's safety and feasibility, minimizing risks of paralysis or brainstem stroke.
• Post-surgery reconstruction used bone grafts, titanium hardware, and mesh, followed by proton therapy to target any remaining tumor cells.
• One year after the procedure, patient Karla Flores remains tumor-free, as surgeons explore broader applications of this minimally invasive approach.