Clarós Pedro, Choffor-Nchinda Emmanuel, Lopez-Fortuny Marta, Claros Andres, Quintana Salvador
a Department of Otolaryngology - Orbital Surgery , Barcelona , Spain.
b Department of Otolaryngology - Head and Neck Surgery , Buea Regional Hospital , Buea , Cameroon.
Acta Otolaryngol. 2019 Aug;139(8):720-725. doi: 10.1080/00016489.2019.1618913. Epub 2019 Jun 1.
: Orbital cavernous haemangioma (OCH) is one of the most common primary orbital tumours in adults. They can encroach on intraorbital or adjacent structures and be considered 'anatomically' malignant. : To report a series of patients that were all managed surgically, with possible specificities and propose predictors of treatment outcome. : We realised a hospital-based retrospective case review including data from 76 patient files. : The mean age was 37.8 years. Unilateral proptosis was observed in all patients. Visual loss was found in 32 patients (42.1%). Findings on eye examination included lagophthalmos (76.3%), blepharoptosis (21.1%), complications of corneal exposure (19.6%), strabismus (13.2%) and fundoscopic abnormalities (60.5%). Abnormal fundoscopy was significantly associated with decreased visual acuity (VA) ( < .001). Small tumours were predominant (65.8%) and size was associated with VA (correlation coefficient = -0.5, < .001). Surgery was mainly by lateral orbitotomy (94.7%), with early post-operative complications in 18 patients (23.7%). Multivariable analysis showed that tumour size, preoperative VA and abnormal fundoscopy were significantly associated with postoperative VA. : Clinical and radiological profiles are consistent. Tumour size, preoperative VA, and abnormal fundoscopy seem to be important factors that could influence outcome expectations. Surgical management is still predominantly by open approaches. Severe complications remain rare.
眼眶海绵状血管瘤(OCH)是成人最常见的原发性眼眶肿瘤之一。它们可侵犯眶内或相邻结构,被认为具有“解剖学上的”恶性特征。
报告一系列均接受手术治疗的患者,探讨可能存在的特异性表现并提出治疗结果的预测因素。
我们进行了一项基于医院的回顾性病例分析,纳入了76份患者病历的数据。
患者的平均年龄为37.8岁。所有患者均出现单侧眼球突出。32例患者(42.1%)存在视力丧失。眼部检查结果包括兔眼(76.3%)、上睑下垂(21.1%)、角膜暴露并发症(19.6%)、斜视(13.2%)和眼底异常(60.5%)。眼底异常与视力下降(VA)显著相关(P<0.001)。小肿瘤占多数(65.8%),肿瘤大小与视力相关(相关系数=-0.5,P<0.001)。手术主要采用外侧开眶术(94.7%),18例患者(23.7%)出现早期术后并发症。多变量分析显示,肿瘤大小、术前视力和眼底异常与术后视力显著相关。
临床和影像学特征一致。肿瘤大小、术前视力和眼底异常似乎是影响预后预期的重要因素。手术治疗仍主要采用开放手术方式。严重并发症仍然少见。