Kumar Ravinder, Vyas Kapil, Jaiswal Gagan, Bhargava Abhishek, Kundu Jyoti
Department of Radiodiagnosis, Geetanjali Medical College and Hospital, Geetanjali University, Udaipur, Rajasthan, India.
Department of Prosthodontics, Geetanjali Dental College and Research Institute, Geetanjali University, Udaipur, Rajasthan, India.
J Ophthalmic Vis Res. 2017 Jan-Mar;12(1):110-112. doi: 10.4103/2008-322X.200169.
To present a case of deep orbital dermoid cyst with emphasis on clinical presentation, imaging spectrum, differential diagnosis and management.
A 28-year-old female was referred to our hospital with chief complaint of drooping of right eyelid and progressive headache. Ocular motility, visual acuity and fundus examination were normal. computed tomography (CT) and magnetic resonance imaging (MRI) revealed a well-defined, intraosseous deep orbital dermoid cyst (5.9 mm × 12.5 mm) located near the apex of right orbit, extending from greater wing of sphenoid into the superior orbital fissure. Due to occulomotor nerve (superior and inferior divisions) compression which passes through the superior orbital fissure, ipsilateral headache and ptosis occurred. Complete surgical excision of cyst was performed using noninvasive extracranial lateral orbitotomy approach. After removal of the cyst, curette and cutting drill were used to thoroughly remove any residual cystic content. Histopathological analysis confirmed the diagnosis. The healing was uneventful postoperatively.
CT and MRI are easy, reliable, safe and effective imaging methods for establishing the diagnosis of orbital dermoid cyst. Size, location and manifestations are the most important determinants of the disease management. Complete surgical excision without rupture of the cyst is the treatment of choice.
报告1例眼眶深部皮样囊肿病例，重点阐述其临床表现、影像学特征、鉴别诊断及治疗方法。
一名28岁女性因右眼睑下垂和进行性头痛为主诉转诊至我院。眼球运动、视力及眼底检查均正常。计算机断层扫描（CT）和磁共振成像（MRI）显示，在右眼眶尖附近有一个边界清晰的骨内眼眶深部皮样囊肿（5.9 mm×12.5 mm），从蝶骨大翼延伸至眶上裂。由于穿过眶上裂的动眼神经（上下支）受压，出现同侧头痛和上睑下垂。采用无创颅外外侧眶切开术入路完整切除囊肿。囊肿切除后，用刮匙和骨钻彻底清除残留的囊内容物。组织病理学分析确诊。术后愈合顺利。
CT和MRI是诊断眼眶皮样囊肿简便、可靠、安全有效的影像学方法。囊肿大小、位置及表现是决定治疗方案的最重要因素。完整手术切除且囊肿未破裂是首选治疗方法。
