Endoscopic endonasal surgery for ORBIT stage Ⅲ orbital cavernous hemangioma: a preliminary experience of 20 cases
10.3760/cma.j.cn115330-20241230-00718
- VernacularTitle:鼻内镜手术治疗ORBIT Ⅲ期海绵状血管瘤：20例初步经验总结
- Author:
Zhidi ZHANG
1
;
Yi WANG
;
Jichao ZHOU
;
Yali DU
;
Qiang ZUO
;
Hailing JIANG
;
Yinghong ZHANG
Author Information
1. 北京大学第三医院耳鼻喉科，北京 100191
- Publication Type:Journal Article
- Keywords:
Orbital neoplasms;
Hemangioma, cavernous;
Endoscopes;
Surgical procedures, operative
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2025;60(3):321-329
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the early efficacy and safety of transnasal endoscopic surgical resection of orbital cavernous hemangioma (OCH) at orbital resection by intranasal technique (ORBIT) stage Ⅲ.Methods:A retrospective study was conducted on 20 patients (20 eyes) who underwent nasal endoscopic surgery to remove ORBIT stage Ⅲ OCH at the Third Hospital of Peking University from July 2021 to July 2024. The cohort were included 10 males and 10 females, aged from 25 to 59 years, with a mean follow-up time of (5.10±4.51) months. Preoperative symptoms included visual field defects in 19 patients (95%), decreased visual acuity in 18 patients (90%), exophthalmos in 2 patients (10%), diplopia in 2 patients (10%), headache in 2 patients (10%), ocular pain in 2 patients (10%), and color vision abnormalities in 1 patient (5%). Data on patient demographics, medical history, imaging data, surgical approach, and postoperative outcomes were collected. Pre-and post-surgical outcomes including best corrected visual acuity (BCVA), visual field, proptosis, and intraocular pressure were compared. Surgical approaches included transnasal endoscopic OCH resection (12 cases, 60%) and transnasal endoscopic combined conjunctival approach OCH resection (8 cases, 40%). The results of the postoperative 2-week review were used as the postoperative short-term efficacy data, and those at 3 months were used for postoperative therapeutic efficacy analysis. SPSS 26.0 statistical software was applied for statistical analysis.Results:In 20 patients, all OCH were completely resected, and the BCVA, visual field, and exophthalmos were significantly improved post-operatively. The differences were statistically significant before and after surgery ( t values were 3.169, 5.127, and 3.350, respectively, all P<0.05). There were no serious complications in the short term after surgery. The short-term complications after endoscopic surgery alone were mainly new-onset diplopia in 1 case (1/12), and the short-term complications after combined approach were new-onset diplopia in 5 cases (5/8) and pupil dilation in 2 cases (2/8). All short-term complications recovered within 3 months, and no serious or permanent complications occurred in the long-term follow. Conclusion:The endoscopic transnasal surgery is a safe and effective approach for complete resection of ORBIT stage Ⅲ OCH, with promising early results.
