De Feudis Francesco, Girotto Riccardo, Balercia Paolo
Division of Maxillofacial Surgery, Department of Neurological Sciences, University Hospitals of Ancona, Ancona, Italy.
Natl J Maxillofac Surg. 2021 Sep-Dec;12(3):410-413. doi: 10.4103/njms.NJMS_420_21. Epub 2021 Dec 13.
The orbit can be affected by primary intraconal lesions as well as cavernous hemangiomas. This article illustrates for the first time the retroseptal dissection (RD) route combined to the superior eyelid crease approach (SECA) to treat a symptomatic hemangioma inside the superomedial intraconal space. It also reviews the main studies about the argument. A 42-year-old woman affected by a mild painful proptosis and some accommodation difficulties in her right eye. The magnetic resonance imaging revealed a soft intraconal mass in the superomedial quadrant of the right orbit. The lesion was removed performing a SECA with RD through an incision inside a natural eyelid crease. Disappearance of pain with an improvement of accommodation was reported immediately. During the whole follow-up, the visual acuity, field examinations, and ocular motility did not reveal any impairment. Our approach represents a valid, quick, not technically demanding and mini-invasive method to access the superomedial intraconal space. Finally, it gives excellent functional and cosmetic results.
眼眶可受到原发性眶内病变以及海绵状血管瘤的影响。本文首次阐述了联合睑缘后分离术（RD）和上睑皱襞入路（SECA）治疗眶内上内侧象限有症状的血管瘤。本文还回顾了关于该论题的主要研究。一名42岁女性，右眼有轻度疼痛性眼球突出和一些调节困难。磁共振成像显示右眼眶上内侧象限有一软性眶内肿块。通过自然睑皱襞内的切口，采用带RD的SECA切除病变。术后疼痛立即消失，调节功能改善。在整个随访期间，视力、视野检查和眼球运动均未发现任何损害。我们的方法是一种有效、快速、技术要求不高且微创的进入眶内上内侧间隙的方法。最后，它能带来优异的功能和美容效果。
