Ophthalmic Plastic Surgery Service, L V Prasad Eye Institute, Hyderabad, Telangana, India.
The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, Telangana, India.
Eur J Ophthalmol. 2021 Sep;31(5):2631-2638. doi: 10.1177/1120672120964686. Epub 2020 Nov 16.
To compare differences in clinical presentation and management outcomes of orbital and periorbital dermoid cysts in children and adults.
A retrospective interventional comparative consecutive case series. 203 patients in (148 children [Age ⩽18 years] and 55 adults [Age >18 years]), who underwent excision biopsy for orbital/periorbital dermoid cyst were included. Outcome measures included the differences in demography, clinical presentations, radiological features, surgical outcomes and histopathology of cysts between children and adults with dermoid cysts.
The mean age noted at excision was 15 years in this cohort of 148 children and 55 adults. Commonest clinical finding observed was a subcutaneous painless mass (94%) and external angular dermoids were commonest in both groups 1 and 2 (51% and 56%). Diminution of vision ( = 0.007), proptosis ( = 0.008), extraocular motility limitation ( = 0.001), strabismus ( = 0.003) and relative afferent pupillary defect ( = 0.02) were significantly more in adults. Orbital involvement and dumbbell dermoids were not significantly different between children and adults. Radiologically, bony fossa formation ( = 0.03), temporal fossa extension ( = 0.04), full thickness bony defect ( = 0.03) and intraosseous presentation ( = 0.005) were significantly more in adults. Comparison of proportion of lesions having intra-operative rupture of dermoid cyst ( = 0.009) and evidence of inflammation on histopathology ( = 0.01) were significantly more in adults. However, recurrence rates were not different between children and adults.
Dermoid cysts are commoner in children, but can also present in adulthood. Secondary visual, orbital, radiologic changes and intra-operative rupture of dermoid cyst are more common in adults compared to children.
比较儿童和成人眼眶和眶周皮样囊肿的临床表现和治疗结果的差异。
回顾性干预性连续病例系列研究。共纳入 203 例（148 例儿童[年龄 ⩽18 岁]和 55 例成人[年龄>18 岁]）接受眼眶/眶周皮样囊肿切除术活检的患者。主要观察指标为皮样囊肿患儿和成人在人口统计学、临床表现、影像学特征、手术结果和囊肿组织病理学方面的差异。
在这组 148 例儿童和 55 例成人中，切除时的平均年龄为 15 岁。最常见的临床发现是皮下无痛性肿块（94%），1 型和 2 型中外侧角皮样囊肿最常见（51%和 56%）。视力下降（ = 0.007）、眼球突出（ = 0.008）、眼外肌运动受限（ = 0.001）、斜视（ = 0.003）和相对传入性瞳孔缺陷（ = 0.02）在成人中更为显著。眼眶受累和哑铃形皮样囊肿在儿童和成人之间无显著差异。影像学上，骨窝形成（ = 0.03）、颞窝延伸（ = 0.04）、全层骨缺损（ = 0.03）和骨内表现（ = 0.005）在成人中更为显著。术中皮样囊肿破裂（ = 0.009）和组织病理学炎症证据（ = 0.01）的比例在成人中也显著更高。然而，儿童和成人的复发率无差异。
皮样囊肿在儿童中更为常见，但也可发生于成人。与儿童相比，成人的次要视力、眼眶、放射学变化和皮样囊肿术中破裂更为常见。
