冠状入路切除巨大眼眶骨瘤1例并67例文献复习

Transcranial approach with a coronal incision for orbit osteomas: Case report and literature review

目的探讨眼眶骨瘤的临床特征及其手术方法。方法报道冠状入路经颅切除的巨大眼眶骨瘤1例病历资料,并通过Pubmed检索近10年中相关眼眶骨瘤的文献,查找病例数在3例及以上的非动物试验文献,进行汇总报告。结果共6篇67例眼眶骨瘤文献入选,眼眶骨瘤最多源于额窦和筛窦骨瘤,其中全切55例(82.1%),部分切除12例(17.9%),手术方法包括经颅、经眶以及鼻内镜手术等。结论眼眶骨瘤的手术路径需要综合考虑肿瘤的大小、位置,冠状切口经颅入路适用于眼眶内深在或者较大的肿瘤。

To investigate the surgical management and clinical characters of patients with orbital osteomas.Methods We reported a case with a large orbit osteoma removed via a transcranial approach with a coronal incision.We also performed a Pubmed search and reviewed all studies published from 2003 to 2013 on orbit osteomas from aminimal cohort of 3 patients Results 6 studies, including 67 patients, were reviewed. Among all the cases, the frontal sinus was the most common location for osteoma, followed by ethmoid sinus. Total resection were performed in 55 ca ses （82.1% ） , while partial resection in were achieved in 12 patients （17.9%）, Different tumor sizes, locations, and different surgeons yielded different surgical methods, such as transcranial approache, endoscopic removal , transorbital approaches , and so on. Conclusion Surgical choice depends on the tumor size, location , and the experience of the surgeon. Transcranial approach is to be indicated if a large or deep osteoma locates in the orbit where it＇ s difficult or impossible to expose by a conventional orbitotomy.