Liu Jinhua, Liu Cuihong, Long Keqin, Liu Honglei
Department of Ophthalmology, Xi'an Fourth Hospital, Xi 'an, Shaanxi Province, China.
Department of Nursing, Xi'an Fourth Hospital, Xi 'an, Shaanxi Province, China.
Orbit. 2025 Feb;44(1):39-48. doi: 10.1080/01676830.2024.2389304. Epub 2024 Aug 19.
Orbital venous malformations (VM) pose challenges in complete resection due to indistinct borders and bleeding proclivity. Current methods for aiding surgical excision of distensible orbital venous malformations are inadequate. We investigated whether external neck compression could facilitate intraoperative distension of venous orbital lesions during surgical excision in patients diagnosed with VM.
Eighteen patients (8 males and 10 females) diagnosed with distensible venous anomalies were enrolled. Neck compression technology, was employed to distend the lesions before puncture embolization using n-butyl-2-cyanoacrylate glue under general anesthesia. The surgical process, along with preoperative to postoperative changes in ocular symptoms, were recorded.
The average surgical duration was 95 min. A mean of 3.41 ml surgical glue was used for embolization. The compression belt maintained pressure at 35-40 mmHg. Total lesion resection was achieved in 12 patients, with 6 patients undergoing subtotal removal not requiring supplementary surgery. Symptoms were entirely alleviated in 17 patients, and signs of distensible lesions during the Valsalva maneuver were absent. One patient underwent secondary surgery for residual eyelid lesions. Minor complications included mild ocular movement restriction, residual subcutaneous induration, transiently increased orbital pressure, and lower lid ectropion in four, three, four, and one patient, respectively. Three patients experienced a mild post-operative visual acuity decrease, although none experienced vision loss.
Direct orbital embolization aided by a jugular vein compression device is safe and demonstrates satisfactory outcomes in orbital varicose vein treatment.
眼眶静脉畸形（VM）由于边界不清和出血倾向，在完全切除方面具有挑战性。目前辅助切除可扩张性眼眶静脉畸形的方法并不充分。我们研究了在诊断为VM的患者手术切除过程中，颈部外部压迫是否能促进眼眶静脉病变的术中扩张。
纳入18例诊断为可扩张性静脉异常的患者（8例男性，10例女性）。在全身麻醉下，采用颈部压迫技术在使用正丁基-2-氰基丙烯酸酯胶进行穿刺栓塞前扩张病变。记录手术过程以及术前至术后眼部症状的变化。
平均手术时间为95分钟。平均使用3.41毫升手术胶进行栓塞。压迫带维持压力在35 - 40毫米汞柱。12例患者实现了病变完全切除，6例患者接受了次全切除，无需补充手术。17例患者症状完全缓解，Valsalva动作时可扩张性病变体征消失。1例患者因残留眼睑病变接受了二次手术。轻微并发症包括轻度眼球运动受限、残留皮下硬结、眼眶压力短暂升高以及分别有4例、3例、4例和1例患者出现下睑外翻。3例患者术后视力轻度下降，尽管均未出现视力丧失。
颈静脉压迫装置辅助的直接眼眶栓塞在眼眶静脉曲张治疗中是安全的，且效果令人满意。
