针对伴有巨大巩膜外扩展的脉络膜黑色素瘤的改良眼球摘除术。
Modified enucleation for choroidal melanoma with large extrascleral extension.
作者信息
Fusetti Stefano, Parrozzani Raffaele, Urban Francesca, Gurabardhi Maceda, Ferronato Giuseppe, Midena Edoardo
机构信息
Department of Maxillofacial Surgery, University of Padova, Via Giustiniani 2, 35128, Padova, Italy.
出版信息
Orbit. 2010 Apr;29(2):70-5. doi: 10.3109/01676830903294883.
PURPOSE
To report the technique and the outcome of modified (enlarged) enucleation via lateral orbitotomy for choroidal melanomas with massive extrascleral extension.
METHODS
5 patients with choroidal malanoma with massive, circumscribed perioptic/posterior extrascleral extension underwent modified enucleation via lateral orbitotomy. After lateral orbitotomy and orbital mass exposure with direct tumor visualization, a long optic nerve stump was cut and the orbital component of the tumor was completely (macroscopically) removed along with the globe in all cases. After haemostasis and orbital reconstruction an orbital implant was then placed. Follow-up was longer than 12 months.
RESULTS
Excellent cosmetic outcome was acheived in all patients (100%) without operative or postoperative complications. At pathologic examination, tumors were completely removed in all cases (100%).
CONCLUSIONS
Modified (enlarged) enucleation via lateral orbitotomy for selectd choroidal melanomas with massive, circumscribed perioptic/posterior extrascleral extension allows complete tumor removal and placement of an orbital implant, avoiding the long healing process of orbital exenteration with excellent clinical and cosmetic outcome.
目的
报告经外侧眶切开术进行改良（扩大）眼球摘除术治疗伴有大量巩膜外扩展的脉络膜黑色素瘤的技术及结果。
方法
5例伴有大量、局限于视盘周围/后部巩膜外扩展的脉络膜黑色素瘤患者接受了经外侧眶切开术的改良眼球摘除术。在进行外侧眶切开术并暴露眶内肿物且能直接观察到肿瘤后，切断长的视神经残端，所有病例均将肿瘤的眶内部分与眼球一并完整（肉眼下）切除。止血及眶重建后植入眶内植入物。随访时间超过12个月。
结果
所有患者（100%）均获得了极佳的美容效果，无手术或术后并发症。病理检查显示，所有病例（100%）肿瘤均被完全切除。
结论
对于伴有大量、局限于视盘周围/后部巩膜外扩展的特定脉络膜黑色素瘤，经外侧眶切开术进行改良（扩大）眼球摘除术可实现肿瘤的完全切除并植入眶内植入物，避免了眶内容剜出术漫长的愈合过程，临床及美容效果良好。
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