Department of Ophthalmology.
Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
J Craniofac Surg. 2022 Sep 1;33(6):e641-e644. doi: 10.1097/SCS.0000000000008720. Epub 2022 Aug 11.
Several surgical methods have been employed, but the management of orbital cavernous venous malformations at the orbital apex remains challenging. The authors present an endonasal endoscopy-assisted removal of an orbital apex cavernous venous malformation compressing the optic nerve with the addition of an inferomedial conjunctival approach. A 43-year-old Asian man presented with an orbital cavernous venous malformation incidentally found radiographically with a history of decreased vision of 20/50 oculus dexter (OD). The patient's visual field index was 22%, with signs of optic neuropathy. An endonasal endoscopic procedure combining transconjunctival and caruncular orbitotomies was adopted because of its deep posterior placement inside the orbit. The cavernous venous malformation was removed without complications, and the visual function of the patients recovered. For these challenging lesions, an endonasal endoscopic technique with an anterior orbitotomy may be a promising alternative. Simple packing material may adequately repair the medial orbital wall; there were no complications during the 12-month follow-up period.
已经采用了几种手术方法，但对于眶尖部海绵状静脉畸形的处理仍然具有挑战性。作者介绍了一种经鼻内窥镜辅助切除压迫视神经的眶尖海绵状静脉畸形的方法，同时采用了内侧下结膜入路。一名 43 岁的亚洲男性因视力下降 20/50 右眼（OD）而偶然发现眼眶海绵状静脉畸形，病史不详。患者的视野指数为 22%，有视神经病变的迹象。由于病变位于眼眶深部，采用了经鼻内窥镜联合结膜和穹隆切开术的方法。在没有并发症的情况下，海绵状静脉畸形被切除，患者的视力功能得到恢复。对于这些具有挑战性的病变，经鼻内窥镜技术联合眶前切开术可能是一种有前途的替代方法。简单的填塞材料可以充分修复内侧眶壁；在 12 个月的随访期间没有发生并发症。
