Artikel
Operative treatment of pure intraorbital lesions – surgical techniques and neuro-ophthalmological outcome
Operative Behandlung rein intraorbitaler Läsionen – operative Techniken und neuro-ophthalmologisches Outcome
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Veröffentlicht: | 4. Juni 2021 |
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Gliederung
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Objective: Resection of pure intraorbital tumors is challenging due to immediate vicinity to the optic apparatus. We report our experience with different intraorbital tumors and discuss classic approaches and obstacles.
Methods: A retrospective chart review at a tertiary neurosurgical center of patients who underwent surgery for intraorbital tumors between 06/2007 – 01/20 was performed.
Results: We included 34 patients (median age 58 with range of 18-87 years, 55.9% [19/34] female, 44.1% [15/34] male). Preoperative proptosis was observed in 67.6% (23/34), visual impairment in 52.9% (18/34), diplopia in 41.2% (14/34) and ptosis in 38.3% (13/34). Intraconal tumors were found in 58.8% (20/34). Most common lesions were cavernous hemangiomas in 26.5% (9/34) and metastases in 14.7% (5/34). Gross total resection (GTR) rate was 73.5% (25/34). Planned biopsy was performed in 14.7% (5/34). Median follow-up time was 15.5 months (range 0-113). 23.5% (8/34) underwent a supraorbital approach, 52.9% (18/34) a pterional approach, 20.6% (7/34) a lateral orbitotomy and 8.8% (3/34) a transnasal approach. One patient underwent a combined technique (transnasal/lateral orbitotomy). Excluding planned biopsies, GTR was achieved in 80.0% (12/15) with a pterional approach, 100% (7/7) with a supraorbital approach, 83.3% (5/6) with a lateral orbitotomy, and 66.6% (2/3) via a transnasal approach. Complication rate requiring surgical intervention was 11.8 % (4/34).
Conclusion: Considering the low operative morbidity and satisfying functional outcome, GTR of intraorbital lesions is feasible. We support the use of classic transcranial and transorbital approaches. More invasive and complicated approaches were not needed in our series.
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