Pediatric neurosurgeon Philipp Aldana explains about the detailed surgery he and Saswata Roy, pediatric craniofacial and skull-base surgeon, performed on Buntheep Chun, a 12-year-old Cambodian girl, to remove a large skull-base brain tumor that was stealing her vision and threatening her life.
Photos by DON BURK/The Times-UnionBuntheep Chun (left) and Gioia Michelotti, director of the Cambodian Christian Arts Ministry, answer questions during a news conference at Wolfson Children's Hospital Wednesday where her brain surgery was explained. The primary surgery took 20 hours, involved the removal of her entire forehead, the upper part of her eye sockets, base of the skull, nasal bones and sinuses.20 Hours of surgery To remove a lemon-sized growth. Challenge Get to the tumor without harming her face or brain.
By LARRY HANNAN, The Times-Union
Buntheep Chun doesn't look like someone who had her entire forehead, the base of her skull and the upper part of her eye sockets taken out and put back together only two months ago.
The orphan from Cambodia looked like a normal 12-year-old Wednesday at Wolfson Children's Hospital in Jacksonville. When asked what she likes best about being in America, Buntheep broke into a big smile and said via an interpreter she likes everything about America.
"I don't think she's talking about the surgical procedures," said her guardian and interpreter, Gioia Michelotti. "She's just very happy with the way people have treated her since we arrived in Jacksonville. We feel very fortunate that God brought us here."
On Dec. 6, Buntheep went through 20 hours of surgery to remove a lemon-sized tumor that was blinding her and breaking through the bones protecting her brain. The challenge doctors faced was getting to the tumor without doing damage to her brain or face.
"I could see this was an enormous tumor that occupied the bottom half of her skull all the way to the back of her nose," said pediatric neurosurgeon Philipp Aldana, who removed nearly the entire growth piece by piece.
Buntheep still has no vision in her right eye, but she can see normally out of her left eye. There appear to be no other complications from the procedure. Doctors hope she will fully regain her sight.
A small portion of the tumor remains, about half the size of a pea. It could not be removed without damaging her brain, doctors said. Buntheep will continue to get regular X-rays to make sure the tumor doesn't grow back.
"There is a 10-20 percent possibility it will grow back," Aldana said.
Buntheep had to go through another surgery later in December after spinal fluid leaked into her skull. The spinal fluid was drained, and doctors pronounced her recovered from the complication on Christmas Day.
To get at the tumor, surgeon Saswata Roy took Buntheep's face apart, and then put it back together again after the tumor was removed. He also removed her nasal bones, and the back of the septum sinuses.
"The tumor was located in one of the hardest locations to get to," Roy said. "For a beautiful 12-year-old girl, you want to get [the tumor] out and leave her with a normal life."
Her face was then reconstructed using the bones of her skull, as well as tissue from the leg.
It took several attempts to remove it. The first one in mid-November had to be halted because of profuse bleeding, leaving it about 80 percent intact.
Bleeding was also a factor in the December surgery.
"We had to stop several times to get the bleeding under control," Aldana said. "Also, portions of her skull bones were mixed in with the tumor."
Wednesday, Aldana and Roy discussed the surgery with the media while Buntheep looked on.
The only hint of what she had gone through was a scar about two inches above her hairline that is expected to fade with additional cosmetic surgery and the growth of her hair.
"I've never seen her scared," Roy said. "It's almost eerie."
Buntheep's father, a soldier, was killed when she was 3. Her mom couldn't afford to keep Buntheep and her older brother so she gave them to the Cambodian Christian Arts Ministry School in Phnom Penh. Michelotti is the school's director.
Buntheep began experiencing vision problems in October, eventually losing sight in her right eye and suffering from cloudy vision in the left eye and numbness in the face.
That led to the discovery of the brain tumor.
Michelotti began writing letters pleading for financial help so Buntheep could get the tumor removed.
Missionaries in Cambodia paid for them to come to the United States, and an elder at a church in Pensacola recommended Wolfson.
"Wolfson has a long history of caring for local children and, at times of urgent need, for children from around the world," said Baptist Health President Hugh Greene in a written statement.
"This is just an extension of our mission.
The doctors who worked on Buntheep did so for free and Wolfson also did not charge for the hospital stay, said Wolfson administrator Larry Freeman. The costs involved were estimated to be between $500,000 and $800,000.
She was released to the Ronald McDonald House on Jan. 11. Barring further medical complications, Michelotti and Buntheep hope to return to Cambodia in March,
When asked if she would have any advice for another child who had to deal with what she went through, Buntheep thought for a few seconds and then whispered something to Michelotti.
"She said, 'Trust God,'" Michelotti said.
By LARRY HANNAN, The Times-Union
Buntheep Chun doesn't look like someone who had her entire forehead, the base of her skull and the upper part of her eye sockets taken out and put back together only two months ago.
The orphan from Cambodia looked like a normal 12-year-old Wednesday at Wolfson Children's Hospital in Jacksonville. When asked what she likes best about being in America, Buntheep broke into a big smile and said via an interpreter she likes everything about America.
"I don't think she's talking about the surgical procedures," said her guardian and interpreter, Gioia Michelotti. "She's just very happy with the way people have treated her since we arrived in Jacksonville. We feel very fortunate that God brought us here."
On Dec. 6, Buntheep went through 20 hours of surgery to remove a lemon-sized tumor that was blinding her and breaking through the bones protecting her brain. The challenge doctors faced was getting to the tumor without doing damage to her brain or face.
"I could see this was an enormous tumor that occupied the bottom half of her skull all the way to the back of her nose," said pediatric neurosurgeon Philipp Aldana, who removed nearly the entire growth piece by piece.
Buntheep still has no vision in her right eye, but she can see normally out of her left eye. There appear to be no other complications from the procedure. Doctors hope she will fully regain her sight.
A small portion of the tumor remains, about half the size of a pea. It could not be removed without damaging her brain, doctors said. Buntheep will continue to get regular X-rays to make sure the tumor doesn't grow back.
"There is a 10-20 percent possibility it will grow back," Aldana said.
Buntheep had to go through another surgery later in December after spinal fluid leaked into her skull. The spinal fluid was drained, and doctors pronounced her recovered from the complication on Christmas Day.
To get at the tumor, surgeon Saswata Roy took Buntheep's face apart, and then put it back together again after the tumor was removed. He also removed her nasal bones, and the back of the septum sinuses.
"The tumor was located in one of the hardest locations to get to," Roy said. "For a beautiful 12-year-old girl, you want to get [the tumor] out and leave her with a normal life."
Her face was then reconstructed using the bones of her skull, as well as tissue from the leg.
It took several attempts to remove it. The first one in mid-November had to be halted because of profuse bleeding, leaving it about 80 percent intact.
Bleeding was also a factor in the December surgery.
"We had to stop several times to get the bleeding under control," Aldana said. "Also, portions of her skull bones were mixed in with the tumor."
Wednesday, Aldana and Roy discussed the surgery with the media while Buntheep looked on.
The only hint of what she had gone through was a scar about two inches above her hairline that is expected to fade with additional cosmetic surgery and the growth of her hair.
"I've never seen her scared," Roy said. "It's almost eerie."
Buntheep's father, a soldier, was killed when she was 3. Her mom couldn't afford to keep Buntheep and her older brother so she gave them to the Cambodian Christian Arts Ministry School in Phnom Penh. Michelotti is the school's director.
Buntheep began experiencing vision problems in October, eventually losing sight in her right eye and suffering from cloudy vision in the left eye and numbness in the face.
That led to the discovery of the brain tumor.
Michelotti began writing letters pleading for financial help so Buntheep could get the tumor removed.
Missionaries in Cambodia paid for them to come to the United States, and an elder at a church in Pensacola recommended Wolfson.
"Wolfson has a long history of caring for local children and, at times of urgent need, for children from around the world," said Baptist Health President Hugh Greene in a written statement.
"This is just an extension of our mission.
The doctors who worked on Buntheep did so for free and Wolfson also did not charge for the hospital stay, said Wolfson administrator Larry Freeman. The costs involved were estimated to be between $500,000 and $800,000.
She was released to the Ronald McDonald House on Jan. 11. Barring further medical complications, Michelotti and Buntheep hope to return to Cambodia in March,
When asked if she would have any advice for another child who had to deal with what she went through, Buntheep thought for a few seconds and then whispered something to Michelotti.
"She said, 'Trust God,'" Michelotti said.
