Das Sucharita, Vathulya Madhubari, Singh Anupam, Chaturvedi Jitendra, Pasricha Arush, Singh Taruna
Department of Ophthalmology, All India Institute of Medical Sciences Rishikesh, Uttarakhand 249203, India.
Department of Burns and Plastic Surgery, All India Institute of Medical Sciences Rishikesh, Uttarakhand 249203, India.
Int J Surg Case Rep. 2023 Sep;110:108782. doi: 10.1016/j.ijscr.2023.108782. Epub 2023 Sep 4.
The orbit is a complex region of the body that is susceptible to several diseases. The term "anterior orbitotomy" describes access to the orbit through the conjunctiva or eyelid from the front. This includes transconjunctival, medial, inferior, and superior approaches. The superior and lateral regions of the posterior orbit can be adequately exposed using a frontotemporal orbitozygomatic approach. The main aim of orbital surgery is to preserve vision. We discuss numerous surgical procedures for ocular tumours in this case series, along with the results of those procedures.
In this case series, various surgical procedures for ocular tumours are discussed, along with their results postoperatively. Meningioma, cavernous hemangioma, dermoid, and Erdheim Chester disease were among the diagnoses. The early surgical outcome parameters in this case series were increased ocular motility and decreased proptosis.
A medial orbitotomy was done as the lesion was in the medial orbit in our first case. In the second, third, and fourth cases, lateral orbitotomies were done because the lesion was in the lateral orbit. The frontotemporal orbitozygomatic approach was used in the fifth and sixth cases with the lesion reaching the orbital apex. Patients with symptoms should consider surgical excision, which involves completely removing the tumour while maintaining the functionality of the muscles and optic nerve. Having a good surgical view and exposure is essential to understand the anatomical relationships in a small area.
The surgical strategy should be used in a manner that maintains visual acuity, limits injury to nearby objects, lowers postoperative morbidity, and is cosmetically acceptable.
眼眶是人体的一个复杂区域，易患多种疾病。“前路眼眶切开术”一词描述了从前部通过结膜或眼睑进入眼眶的方法。这包括经结膜、内侧、下方和上方入路。使用额颞眶颧入路可以充分暴露眼眶后部的上外侧区域。眼眶手术的主要目的是保留视力。在本病例系列中，我们讨论了针对眼部肿瘤的多种手术方法及其手术结果。
在本病例系列中，讨论了针对眼部肿瘤的各种手术方法及其术后结果。诊断包括脑膜瘤、海绵状血管瘤、皮样囊肿和厄尔德里希-切斯特病。本病例系列中的早期手术结果参数包括眼球运动增加和眼球突出度降低。
在我们的第一例病例中，由于病变位于眼眶内侧，因此进行了内侧眼眶切开术。在第二、第三和第四例病例中，由于病变位于眼眶外侧，因此进行了外侧眼眶切开术。在第五和第六例病变累及眶尖的病例中，使用了额颞眶颧入路。有症状的患者应考虑手术切除，即完全切除肿瘤同时保持肌肉和视神经的功能。拥有良好的手术视野和暴露对于了解小区域内的解剖关系至关重要。
手术策略的应用应能保持视力、限制对周围组织的损伤、降低术后发病率且在美容上可接受。
