Transnasal endoscopic removal of orbital apex cavernous hemangioma
10.3760/cma.j.issn.1673-0860.2013.03.007
- VernacularTitle:内镜下经鼻切除眶尖海绵状血管瘤
- Author:
Na ZHANG
1
;
Qian HUANG
;
Bing ZHOU
;
Ji-Tong SHI
;
Cheng-Shuo WANG
;
Sheng-Zhong ZHANG
Author Information
1. 100730,首都医科大学附属北京同仁医院耳鼻咽喉头颈外科教育部耳鼻咽喉头颈科学重点实验室(首都医科大学)
- Keywords:
Endoscopy;
Otorhinolaryngologic surgical procedures;
Orbital neoplasms;
Hemangioma,cavernous
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2013;48(3):204-208
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the strategy and indications of endoscopic transnasal resection of orbital apex cavernous hemangiomas (OACH).Methods Eleven patients aged from 30 to 62 years-old diagnosed as OACH bypostoperative histopathology were reviewed retrospectively.Four males and 7 females were included.Both ophthalmological examination and rhinologic evaluation were adopted preoperatively.The surgeries were carried out under general anesthesia endoscopically by the same senior surgeon.After ethmoidectomy,the orbital lamina papyracea was opened,and the orbital fat and muscles were pushed back into the orbit by using the brain cotton,and then the orbital tumor was removed.The patients were kept follow-up both in ophthalmologic and rhinologic departments.Results As suggested by preoperative imagings,4 lesions located in the extraconal space (nasal side),6 between the optic nerve and the internal rectus muscle of the intraconal space,and 1 outside the optic nerve in the intraconal space.Total resection was achieved in 9 cases,and orbital decompressions were done in 2 cases.Meanwhile,orbital wall reconstruction was done in 7 cases.The follow up ranged from 6 to 47 months.Seven patients achieved visual acuity improvement and no deteriorations were found in other 4 patients.Defects of vision field in 3 patients disappeared after 2 weeks.No operative or postoperative complications occurred.Conclusions The OACH located in the nasal side of extraconal space and between the optic nerve and the internal rectus muscle of the intraconal space can be accessed endoscopically by intranasal approach.Using the brain cotton to push the orbital fat and muscles back into the orbit and an experienced endoscopic surgeon are important to access a successful intranasal endoscopic removal of orbital apex tumor.
