gms | German Medical Science

82. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

01.06. - 05.06.2011, Freiburg

Improvement of visual acuity after removal of an orbital vascular malformation

Meeting Abstract

Suche in Medline nach

  • corresponding author presenting/speaker Marc Weberpals - University Hospital, ENT Department, Homburg/Saar, Germany
  • author presenting/speaker Basel Al-Kadah - University Hospital, ENT Department, Homburg/Saar, Germany
  • presenting/speaker Adrienne Mayer - University Hospital, Institue for Pathology, Homburg/Saar, Germany
  • author presenting/speaker Bernhard Schick - University Hospital, ENT Department, Homburg/Saar, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 82nd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Freiburg, 01.-05.06.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11hno65

DOI: 10.3205/11hno65, URN: urn:nbn:de:0183-11hno655

Veröffentlicht: 3. August 2011

© 2011 Weberpals et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: While acute visual loss requires immediate therapeutic action in regard to low retinal ischaemia tolerance, it is uncertain whether improvement of progredient visual loss can be achieved by treatment of slowly progredient lesions.

Methods/Results: A 46-year old patient suffering from a progredient exopthalmus over several weeks and loss of visual acuity (sc 1/40) on the right side was presented to us when diplopia in gazing upwards or temporal occurred. In addition to ophthalmologic and ENT-assessment, ultrasonography, computed tomography and magnetic resonance imaging of the orbit were performed, showing a vascular tumor of the retrobulbar orbital space on the right side. After completion of diagnostics we refrained from performing biopsy and performed a complete removal of the vascular malformation via lateral orbitotomy. Immediately after surgery an improvement of visual acuity and loss of diplopia could be attested. The histologic assessment confirmed our clinical assumption of a cavernous haemangioma.

Conclusion: A vascular malformation has to be considered in patients presenting slowly progredient exophthalmus and loss of visual acuity. The presented lateral orbitotomy is a functionally and aesthetically valuable approach to the orbit, allowing removal of such lesions with minimal blood loss. Should loss of visual acuity increase slowly over a longer period of time, improvement of visual acuity after removal of a vascular orbital tumor is still possible.


References

1.
Casper DS, Chi TL, Trokel SL. Orbital disease: imaging and analysis. New York: Thieme Medical Publisher; 1993. p. 81-97.
2.
Shields JA, Bakewell B, Augsburger JJ, Flanagan JC. Classification and incidence of space-occupying lesions of the orbit. Arch Ophthalmol. 1984;102:1606–11.
3.
Moss HM.Expanding lesions of the orbit. A clinical study of 230 consecutive cases. Am J Ophthalmol. 1962;54:761-70.
4.
Mauriello JA, Flanagan JC. Surgical approaches to the orbit. In: Management of orbital and ocular adnexal tumors and inflammations. Berlin: Springer; 1990. p. 149–525.
5.
Demirci H, Shields CL, Shields JA, Honvar SG, Mercado GJ, Tovilla JC. Orbital Tumors in Older Adult Population. Ophthalmology. 2002;109:243-8.