Meenakshi Hospital Thanjavur, has successfully performed complex neurosurgeries to remove exceptionally rare ocular tumours in two farmers, restoring their vision that had been threatened by pressure on the optic nerves. Along with removing the tumours, the surgical team also reconstructed the orbital walls to ensure aesthetic recovery. Both procedures were completed successfully, and the patients are now recovering well.
In one case, a 30-year-old farmer was found, on scans, to have a tumour inside the orbit extending into the brain. Measuring about 3x2x3 cm, it was located deep within the intraconal space of the orbit, an area surrounded by the muscles that control eye movement. The condition, known as an intraconal dermoid, is exceptionally rare, with only around 40 cases reported worldwide in medical literature. The second patient, a 40-year-old farmer, was diagnosed with a tumour in the right eye measuring 11x7x6 cm. The condition, known as an extraconal epidermoid extending into brain and skull base, is extremely rare, with only 60 cases reported worldwide to date.
The surgical team employed novel neurosurgical approaches, performing a roof orbitotomy to remove the 3x2 cm intraconal dermoid and a lateral orbitotomy to excise the 11x7x6 cm extraconal epidermoid, successfully clearing both tumours. In the roof orbitotomy, a portion of the orbital roof, the bony upper wall of the eye socket, was temporarily removed to access the tumour. In the lateral orbitotomy, a specialised procedure, a direct and safe access was created to access the tumour located outside the muscle cone of the eye. The hospital also carried out reconstruction surgeries to restore the natural appearance of the eye socket.
The surgical team at Meenakshi Hospital, led by Dr. N. Arunkumar, Senior Consultant – Neurosurgery, meticulously planned and executed both procedures, ensuring complete tumour clearance while preserving ocular function and vision.
In his comments, Dr. Arunkumar, Senior Consultant – Neurosurgery Meenakshi Hospital Thanjavur said: “We used precision surgical methods to remove these benign tumours. One was an intraconal dermoid lodged deep inside a patient’s eye socket. While dermoids usually occur outside the muscle cone, intraconal dermoids are rare and can lead to progressive eye bulging and vision problems if left untreated. Since the tumour was deeply located inside the orbit, it required a roof orbitomy, where we temporarily removed part of the orbital roof to reach and excise the lesion. The second case involved a massive extraconal epidermoid measuring 11x7x6 cm extending into brain and skull base which had caused considerable pressure within the orbit. For this, we performed a lateral orbitotomy, a specialised procedure that allows direct and safe access to orbital lesions outside the muscle cone. Both were complex brain surgeries that required us to make small openings in the skull to safely access and remove the tumours. In addition, we performed orbital wall reconstruction in both patients to restore their natural appearance, and in one case, we combined endoscopic assistance to ensure precision. We are pleased that both patients have regained their vision, their appearance has returned to normal, and most importantly, there was no damage to brain structures or tissues during the operations.”
Dr. G. Arimanickam, Senior Consultant – Anesthesiology and Dr. V. Praveen, Deputy Medical Superintendent, Meenakshi Hospital Thanjavur were also present during the press meet.