眼眶神经纤维瘤的临床分析

Diagnosis and treatment of orbital neurofibromas

目的探讨眼眶神经纤维瘤的诊断和治疗方法。方法应用CT、B型超声、彩色多普勒超声和MRI协助诊断,结合辅助检查制定手术进路,切除肿瘤并进行组织病理学检查。结果诊断眼眶神经纤维瘤的14例中,主要以眶部肿物、眼睑肿胀与眼球突出就诊,眼部表现与影像学表现多样化,部分伴有全身表现。2例有并发症,3例有遗传史。其中局限型3例,弥漫型8例,丛状型3例。在手术治疗中,5例经外侧开眶,9例经前路开眶。结论CT、B型超声、彩色多普勒超声和MRI等现代影像学技术,在诊断眼眶神经纤维瘤与选择合适的手术方式中有重要价值。

Objective Orbital neurofibromas is the benign tumor from peripheral nerve. The treatment approach to orbital neurofibromas is multiplieity because of their different appearance of imaging. This study was to investigate the clinical diagnosis and treatment outcome of orbital neurofibromas, Methods Multiple imaging examinations including computed tonography （CT） ,B-scan uhrasonography, color Doppler imaging （CDI）, and magnetic resonance imaging （MRI）were utilized for the diagnosis,select of operative approach and management of lesion in 14 series patients with orbital neurofibromas. All of the cases were collected in Tianjin Eye Hospital. The tissue specimens of tumor were obtained during the operation for histopathological examination. Results The major complains of patients with orbital neurofibromas were orbital tumor,swelling of the blepharon and exophthalmos, and their manifestations in orbit and imageology were manifold. Part of the patients showed the systemic abnormal,and 2 of them accompanied with complications,and 3 patients had the history of heritage. Among the 14 patients,local neurofibromas was found in 3 cases, diffuse neurofibromas in 3 cases, and plexiform neurofibromas was in 8 cases. The anterior orbitomy were done in 4 eyes during the operation and the lateral orbitomy were performed in 9 eyes. Conclusion The imaging examination is helpful in the diagnosis and selection of the operative fashion for orbital neurofibromas.