Castelnuovo Paolo, Fiacchini Giacomo, Fiorini Francesca Romana, Dallan Iacopo
Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria-Varese, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Head and Neck Surgery & Forensic Dissection Research Center (HNS&FDRC), Department of Biotechnology and Life Sciences, University of Insubria-Varese, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
Surg J (N Y). 2018 Jun 20;4(3):e105-e109. doi: 10.1055/s-0038-1661417. eCollection 2018 Jul.
Orbital lesions are traditionally managed through external approaches when laterally located, and through a transnasal approach or other external approaches when medially located. However, when the lesion is superomedially located, it may determine a technical challenge. In this study, we present the case of a patient with a superomedial intraconal venous malformation of the left eye. We addressed the mass through a combined approach, using the transnasal route as the main approach, and the superior eyelid approach to push down the lesion to facilitate the excision. We have called this approach "push-pull technique." We achieved a complete resection of the lesion and did not observe any intraoperative or postoperative complications. The last follow-up at 6 months postoperatively showed no recurrence, and the patient was satisfied and completely recovered. According to our experience, the "push-pull" technique seems to be a safe procedure and might be considered a valid alternative to address selected superomedial intraconal lesions.
传统上，眼眶病变位于外侧时通过外部入路处理，位于内侧时通过经鼻入路或其他外部入路处理。然而，当病变位于眶上内侧时，可能会带来技术挑战。在本研究中，我们展示了一例左眼眶上内侧圆锥内静脉畸形患者的病例。我们采用联合入路处理该肿物，以经鼻入路为主，同时采用上睑入路将病变向下推以利于切除。我们将这种方法称为“推拉技术”。我们实现了病变的完全切除，且未观察到任何术中或术后并发症。术后6个月的最后一次随访显示无复发，患者满意且已完全康复。根据我们的经验，“推拉”技术似乎是一种安全的手术方法，可能被视为处理某些眶上内侧圆锥内病变的有效替代方法。
