Liao H F, Wang Y H, Huang Q, Gan P Y, Wang A A
Affiliated eye hospital of Nanchang University, Nanchang 330000, China.
Zhonghua Yan Ke Za Zhi. 2017 Apr 11;53(4):288-293. doi: 10.3760/cma.j.issn.0412-4081.2017.04.011.
To explore the effect of the surgical removal of orbital deep cavernous hemangioma following the concept of minimal surgical invasion. Retrospective case series study. Sixty-three cases with surgical removal of deep orbital cavernous hemangioma were collected in the Affiliated Eye Hospital of Nanchang University from May 2012 to August 2015. There were 29 males and 34 females. The age was from 17 to 69 years with mean age (45±11) years.The surgical methods the conjunctival approach orbital surgery, lateral orbital surgery, medial skin orbital surgery, lateral orbital conjunctiva conjunctival pathway and endoscopic nasal approach were chosen for different cases. The visual acuity, visual field and electrophysiological examination were analyzed before and after operation. Sixty-three patients underwent complete surgically removal of the tumor. Among them, 32 cases were conducted by conjunctival approach, 24 cases had improved visual acuity, 5 cases had no change of visual acuity, 3 cases had decreased visual acuity. Seventeen cases performed with lateral open orbital surgery had improved visual acuity in 11 cases, no change in visual acuity in 3 cases and decreased visual acuity in 3 cases postoperatively. Six cases with approach of the medial orbital surgery had improved visual acuity in 4 cases, no change of visual acuity in 1 case and decreased visual acuity in 1 case postoperatively. Six cases with approach of outside open orbital surgery combined with medial conjunctival pathway had improved visual acuity in 4 cases, no change of visual acuity in 1 case and decreased visual acuity in 1 case postoperatively. Two cases performed with endoscopic nasal approach. One of them had normal visual function and no change after surgery. Another had impaired visual function pre-operatively and it came back to normal postoperatively. With the concept of minimal surgical invasion, the choice of appropriate surgical approach can save patients with the greatest degree of visual function and even improve the visual function of the patients with orbital cavernous hemangioma. .
探讨遵循微创外科理念手术切除眼眶深部海绵状血管瘤的效果。回顾性病例系列研究。收集2012年5月至2015年8月在南昌大学附属眼科医院手术切除眼眶深部海绵状血管瘤的63例病例。其中男性29例，女性34例。年龄17至69岁，平均年龄（45±11）岁。针对不同病例选择结膜入路眼眶手术、外侧开眶手术、内侧皮肤入路眼眶手术、外侧开眶联合结膜入路以及鼻内镜入路等手术方式。分析手术前后的视力、视野及电生理检查情况。63例患者均手术完整切除肿瘤。其中，结膜入路32例，术后视力提高24例，视力无变化5例，视力下降3例。外侧开眶手术17例，术后视力提高11例，视力无变化3例，视力下降3例。内侧眼眶手术入路6例，术后视力提高4例，视力无变化1例，视力下降1例。外侧开眶联合内侧结膜入路6例，术后视力提高4例，视力无变化1例，视力下降1例。鼻内镜入路2例。其中1例术前视功能正常，术后无变化。另1例术前视功能受损，术后恢复正常。遵循微创外科理念，选择合适的手术入路可最大程度挽救患者视功能，甚至改善眼眶海绵状血管瘤患者的视功能。
