Purpose To evaluate the long-term pr ognosis of visual function in patients with orbital cavernomas after conser-vative and surgical treatment.Design Interventional case series.Methods The authors describ e the outcom...Purpose To evaluate the long-term pr ognosis of visual function in patients with orbital cavernomas after conser-vative and surgical treatment.Design Interventional case series.Methods The authors describ e the outcome of 20patients with cavernous hemangioma s of the orbit treated in their departments between 1988and 2003.This prospec-tive study included five cases follo wed by clinical and ra-diologic observation and 15cases of symptomatic tumors that were completely removed by mean s of a frontotemporal or by means of a transconjunctival ap proach.The clinical characteristics of orbital cavernomas were analyzed together with their appropriate treatment.F urthermore,the authors present the unusual case of a patient suffering from pro-gressive visual deterioration from a cerebral cavernoma compressing the optic nerve.Results The follow up period was between 3and 10years.All orbita l cavernomas in the group of conservatively managed patients remained stable.The transconjunctival excision of a medially located lesion was uncomplicated.The frontotemporal approach was cho-sen for large tumors situated in the p roximity of the orbital apex and was associated with a higher number of compli-cations.A good overall outcome of visual function and patient satisfaction was achieved i n 11of 14cases operated on by craniotomy.Conclusion The com bination of clinical signs and magnetic resonance imagin g(MRI )is highly sensitive and specific for the diagn osis of orbital caver-nomas.In the presence of visual dete rioration clearly at-tributable to the tumor we recommend immediate surgery,while lesions producing solely exop hthalmos can safely be followed by observation.The transc ranial approach offers excellent exposure and a rewarding c osmetic result and may be considered for large lesions superior and medial to the optic nerve,especially if they involve the orbital apex.展开更多
文摘Purpose To evaluate the long-term pr ognosis of visual function in patients with orbital cavernomas after conser-vative and surgical treatment.Design Interventional case series.Methods The authors describ e the outcome of 20patients with cavernous hemangioma s of the orbit treated in their departments between 1988and 2003.This prospec-tive study included five cases follo wed by clinical and ra-diologic observation and 15cases of symptomatic tumors that were completely removed by mean s of a frontotemporal or by means of a transconjunctival ap proach.The clinical characteristics of orbital cavernomas were analyzed together with their appropriate treatment.F urthermore,the authors present the unusual case of a patient suffering from pro-gressive visual deterioration from a cerebral cavernoma compressing the optic nerve.Results The follow up period was between 3and 10years.All orbita l cavernomas in the group of conservatively managed patients remained stable.The transconjunctival excision of a medially located lesion was uncomplicated.The frontotemporal approach was cho-sen for large tumors situated in the p roximity of the orbital apex and was associated with a higher number of compli-cations.A good overall outcome of visual function and patient satisfaction was achieved i n 11of 14cases operated on by craniotomy.Conclusion The com bination of clinical signs and magnetic resonance imagin g(MRI )is highly sensitive and specific for the diagn osis of orbital caver-nomas.In the presence of visual dete rioration clearly at-tributable to the tumor we recommend immediate surgery,while lesions producing solely exop hthalmos can safely be followed by observation.The transc ranial approach offers excellent exposure and a rewarding c osmetic result and may be considered for large lesions superior and medial to the optic nerve,especially if they involve the orbital apex.
