结膜切口的眼眶肌锥内海绵状血管瘤摘除

Transconjunctival surgical extirpation of intraorbital cavernous hemangioma

目的:探讨眼眶肌锥内海绵状血管瘤经结膜切口入路进行摘除的可行性。方法:选取于我院行眼眶肌锥内海绵状血管瘤摘除患者53例,其中肿瘤最大直径4.2cm,最小0.8cm。全身麻醉下做眼睑外眦切开,角膜缘后7～8mm处1/3～1/2周结膜切开,暴露肿瘤前端。沿肿瘤表面钝性分离,肿瘤与周围组织完全分离后夹住肿瘤前端,拉出。肿瘤巨大从结膜切口拉出困难时,用针刺破并挤压肿瘤,挤出部分血液,使肿瘤体积变小后再将肿瘤拉出。结果:患者53例眼眶肌锥内海绵状血管瘤全部完整取出,无明显瘢痕形成,眼部形态满意。结论:结膜切口的眼眶肌锥内海绵状血管瘤摘除不需要切开眼眶外侧壁,手术时间短,创伤小,手术费用低;创口仅位于眼睑外眦角和结膜,术后无明显的瘢痕形成。无术后的容貌改变,美容效果好,值得推荐。

AIM： To discuss the feasibility of transconjunctival surgical removal of intraorbital cavernous hemangioma. METHODS：We recruited 53 patients with intraorbital cavernous hemangioma, the largest diameter was 4.2cm, and the smallest diameter was 0. 8cm. After general anesthesia, the outer canthus should be incised, and the 1/3-1/2 circle of conjunctiva 7 to 8ram should be scissored after corneal margin to expose the tumor. The tumor should be bluntly separated along its surface. After completely separating the tumor and surrounding tissues, the front area of tumor should be clamped and pulled out. If the tumor is too large to be pulled out from the cut, it can be punctured to press out some blood so that it can be smaller to be pulled out. RESULTS：lntraorbital cavernous hemangiomas of the 53 patients were all excised completely with no obvious scar formed and satisfied appearance. CONCLUSION. The method of transconjunctival surgical removal of intraorbital cavernous hemangioma has the following merits, unnecessary opening the lateral wall oforbit, short duration of operation procedure, small injury and low cost. Incision is just outside the outer canthus angle and conjunctiva and there is no obvious scar formed after operation. This method is worth being recommended because of the perfect appearance