结膜入路摘除眶内海绵状血管瘤的临床分析

Clinical outcomes of transconjunctival extraction of introconal orbital cavernous hemangioma

目的探讨结膜入路摘除眶内海绵状血管瘤的适应证选择、手术技巧及并发症处理。方法回顾性分析2004年8月至2011年11月于我院经结膜入路手术治疗的海绵状血管瘤42例(42只眼)。结果 1例改行外侧开眶,3例改前路开眶,2例未寻找到肿瘤为保存视功能放弃手术,其余均顺利切除肿瘤。除1例视力丧失外,无明显并发症。结论微创结膜入路摘除眶内海绵状血管瘤安全有效,关键在于术前对肿瘤性质、位置、粘连程度的正确判断以及术者的手术技巧和临床经验。

Objective To assess the selection criteria, surgical approach and complications of transconjunctival extraction of intraconal orbital cavernous hemangioma. Methods Medical records were reviewed for 42 cases of intraconal orbital cavernous hemangiomas that received transconjunctival extraction in our hospital from August 2004 to November 2011. Results There was one case that required lateral orhitotomy, 3 cases that required anterior orhitotomy, and 2 cases in which the hemangiomas could not be located and the operation had to be ended to prevent blindness. All other cases were successfully treated. Blindness occurred in 1 case;otherwise there was no major complications observed. Conclusion Transconjunctival extraction of intraconal orbital cavernous hemangioms is a safe and effective surgical procedure. It is im- pertant to carefully study the quality, location, and relationship to neighboring tissue of the tumor before the surgery. Sur- geon~ skill and experience also play an important role in a successful treatment.