Joshua Harrison had just gotten back from a trip to Europe when he noticed a growth near his eye.
He assumed it was swelling due to a sinus infection so he went to urgent care and was prescribed antibiotics. But when the pain got worse instead of better, he went back to urgent care where the doctor told him, “I’ve never seen anything like this. You need to go to the emergency room now.”
The growth on his face had gotten so large, Harrison could barely see. A friend drove him to Bascom Palmer Eye Institute for a CT scan. Within 30 minutes he was told he had a massive benign bony tumor and was transferred to the hospital.
He didn’t just have a tumor, however. He also had an active infection. He spent eight days in the hospital to treat the infection before he was allowed to go home.
A Challenging Surgery
Doctors had to determine how to remove his tumor. Doing so would not be simple, explained Corinna Levine, M.D., M.P.H., a UHealth—University of Miami Health System sinus and skull base surgeon.
“It was a really large tumor that was growing into the eye and eye space,” said Dr. Levine, also an assistant professor of clinical otolaryngology at the University of Miami Miller School of Medicine. “His eye was being pushed out and the tumor extended between two of the eye muscles, so it was getting close to the vision nerve. The tumor also extended into the sinuses and the bone that separates the brain from the nasal cavity.”
Dr. Levine brought Harrison’s case to the skull base tumor board, a multidisciplinary group of specialized surgeons who come together to review cases and develop a treatment plan.
“Everybody is together at one time to look at a case to make sure that we all agree, even if not everybody is participating in that case,” Dr. Levine said.
The tumor board determined that there was a chance to remove the tumor without a disfiguring surgery. It would require using a leading-edge surgical technique, transorbital endoscopic surgery. This specialized surgery uses tiny telescopes and precision instruments to resect tumors without removing part of the facial bones.
Surgery “Almost Like a Little Dance”
Two weeks after his infection was treated, Harrison returned to the hospital. A team of surgeons, including a facial plastic surgeon, Shekhar Gadkari, M.D., a UHealth oculoplastic surgeon and Miller School professor of facial, plastic and reconstructive surgery, Kevin Clauss, M.D. and Dr. Levine herself worked through his nose and tiny incisions in his eye to extract the bony tumor, piece by piece. Then they painstakingly repaired the tumor site.
Surgeons operating together “is almost like a little dance,” said Levine. The tumor “has to be taken out in multiple pieces. And as you’re doing that you want to make sure you protect all the important things, such as the skull base, the brain, the eye and the muscles in the eye.”
Had the surgery been done without such a team, Harrison may have lost his vision or needed multiple surgeries that would have resulted in visible, severe scarring.
During the first week of Harrison’s recovery in the hospital, his face remained swollen and his eye bled. It may sound unpleasant, but he said that the exceptional care and attention he received from the nursing staff meant that the recovery “wasn’t challenging at all.”
Harrison’s surgical team are thrilled with his recovery. His skull base and sinuses are healed. He has excellent vision and his eye is back in the normal position. Harrison is also back doing all his pre-surgery activities. It is nearly impossible to tell he had surgery.
