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经鼻内镜眶海绵状血管瘤切除术:我们的 23 例经验。

Transnasal endoscopic resection of orbital cavernous hemangiomas: our experience with 23 cases.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, PR China.

Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, PR China.

出版信息

Int Forum Allergy Rhinol. 2019 Nov;9(11):1374-1380. doi: 10.1002/alr.22383. Epub 2019 Aug 23.

Abstract

BACKGROUND

The aim of this work was to present our single-center experience on orbital cavernous hemangiomas managed using an endonasal endoscopic approach.

METHODS

The study design used was one-institutional retrospective review. Twenty-three cases of orbital cavernous hemangioma were analyzed and followed up.

RESULTS

There were 10 males and 13 females, with an average age of 46.1 years, included in our study. Seven cases were extraconal, 16 cases were intraconal, and in 10 of the patients the optic nerve was involved and compressed. Total resection of the tumor was achieved in 16 cases; of the remaining 7 cases, partial tumor resection and orbital decompression were conducted, orbital decompression was conducted in 2 cases, and orbital decompression and optic nerve decompression were conducted in 3 cases. Visual acuity in 9 patients improved significantly, as 16 of the 20 patients with a preoperative visual field defect had a smaller defect after surgery.

CONCLUSION

This study adds to the literature showing that endoscopic transnasal surgery is likely a reasonable option for patients with the orbital cavernous hemangiomas medial of the optic nerve. With greater experience, skilled surgical technique, and careful operation, better clinical efficacy can be achieved.

摘要

背景

本研究旨在介绍我们采用经鼻内镜入路治疗眼眶海绵状血管瘤的单中心经验。

方法

本研究采用单中心回顾性研究设计。分析并随访了 23 例眼眶海绵状血管瘤患者。

结果

本研究共纳入 10 例男性和 13 例女性患者,平均年龄为 46.1 岁。7 例为眶外型,16 例为眶内型,10 例患者视神经受累并受压。16 例患者肿瘤全切除;其余 7 例患者行部分肿瘤切除和眼眶减压术,2 例行眼眶减压术,3 例行眼眶减压和视神经减压术。9 例患者视力明显改善,20 例术前视野缺损患者中,16 例术后视野缺损较小。

结论

本研究增加了文献证据,表明对于视神经内侧的眼眶海绵状血管瘤患者,经鼻内镜手术可能是一种合理的选择。随着经验的增加、熟练的手术技术和精细的操作,可以获得更好的临床疗效。

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