Purpose Orbital cavernous hemangiomas, particularly those within the retrobulbar space, are approached by neurosurgeons as well as by ophthalmic surgeons. Several surgical techniques have been applied over the past decades. Less traumatic approaches in this functionally and cosmetically important region are desirable. We describe a transconjunctival approach in 39 patients with orbital cavernous hemangiomas.
Methods 39 patients with orbital cavernous hemangioma were treated with transconjunctival orbitotomy. The clinical and radiologic characteristics of orbital cavernous hemangiomas were analyzed in course of their appropriate treatment.
Results In all patients, cavernous hemangiomas were just behind the globe or compressing it. CT and MRI showed orbital cavernous hemangiomas as roundish, well-defined intraconal masses. In 37 cases, the tumors were removed intact, and only one of them suffered permanent visual loss as a result of intraoperative hemorrhage. In the other two cases, most fragments of tumors were incompletely removed. Visual acuity increased in 6 of 9 cases with primary visual impairment. 32 patients with primary proptosis were resolved completely. Six patients with visual field defect were also improved.
Conclusions Retrobulbar intraconal cavernous hemangiomas can be removaled successfully through a transconjunctival approach. However, if the tumor is close to or touching the orbital apex, adhering tightly to retrobulbar tissue, or combining with large draining veins, operation through other approaches must be considered. |
