10例眼眶肿瘤手术临床分析

Clinical analysis of 101 cases of orbital tumor operation

目的分析原发性眼眶肿瘤的组织来源、手术进路及手术效果。方法回顾性分析5年开眶手术治疗的眼眶肿瘤101例。结果前十位的眼眶肿瘤分别是:海绵状血管瘤22例(21．78％),静脉性血管瘤10例(9．9％),(表)皮样囊肿泪腺10例(9．9％),泪腺混合瘤8例(7．92％),炎性假瘤7例(6．93％),脑膜瘤6例(5．94％),腺样囊性癌5例(4．95％),淋巴瘤4例(3．96％),肉瘤3例(2．97％),神经鞘瘤2例(1．98％)。手术方法包括前路入眶68例,外侧开眶27例,眶内容6例,术后复发4例。结论开眶手术的术式选择与肿瘤的性质、位置、粘连情况、病变范围密切相关。术前对肿瘤的性质、位置、粘连程度的正确判断和手术操作技巧可减少术后复发等并发症。术后复发病例主要为脑膜瘤及泪腺肿瘤。

Objective To analyze the histological source of primary orbital tumors and the ways,surgical approaches,effects of orbitotomy. Methods Retrospective analysis 101 cases of different primary orbital tumors with different orbital surgical procedures in five years. Results The first ten hight-incidence primary orbital tumors were as follows:cavernous hemangioma (21.78%),venous hemangious (9.9%), (epi)dermoid (9.9%), pleomorphic adenoma (7.92%), pseudotumour of orbit (6.93%), meningioma (5.94%), adenoid cystic carcinoma (4.35%) ,lymphoma (3.96%), rhabdomyosarcoma (2.97%),neurilemoma (1.98%).Anterior orbitotomy were performed on 68 patients,and lateral orbitotomy were 27 patients.Orbital exanteration were performed on 6 patients.There were 4 patients recurrence after operation. Conclusion The manner of the opration was in related with the nature, position, adhesion condition and the affected area of the orbital tumors.The proper estimate for the dignosis,position and adhesion of tumors and operation skill was able to decrease the recurrence rate and improve the successful rate of orbital surgery.The meningioma and lacrimal gland tumor had high recurrent rates.