Treatment and long-term outcome of patients with orbital cavernomas
| Autor: | G. H. Kolling, Stefan Kunze, Hans H. Steiner, Alexander F. Scheuerle, Alfred Aschoff |
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| Přispěvatelé: | Goisis, M, Guareschi, M, Miglior, S |
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty genetic structures Exophthalmos medicine.medical_treatment Visual Acuity Ophthalmologic Surgical Procedures Hemangioma medicine Humans Prospective Studies orbital tumors treatment Prospective cohort study Craniotomy Aged medicine.diagnostic_test business.industry Magnetic resonance imaging Middle Aged Prognosis medicine.disease Magnetic Resonance Imaging eye diseases Surgery Ophthalmology Hemangioma Cavernous medicine.anatomical_structure Optic nerve Orbital Neoplasms Female medicine.symptom Tomography X-Ray Computed business Ophthalmologic Surgical Procedure Follow-Up Studies Orbit (anatomy) |
| Zdroj: | American Journal of Ophthalmology. 138:237-244 |
| ISSN: | 0002-9394 |
| DOI: | 10.1016/j.ajo.2004.03.011 |
| Popis: | Purpose To evaluate the long-term prognosis of visual function in patients with orbital cavernomas after conservative and surgical treatment. Design Interventional case series. Methods The authors describe the outcome of 20 patients with cavernous hemangiomas of the orbit treated in their departments between 1988 and 2003. This prospective study included five cases followed by clinical and radiologic observation and 15 cases of symptomatic tumors that were completely removed by means of a frontotemporal or by means of a transconjunctival approach. The clinical characteristics of orbital cavernomas were analyzed together with their appropriate treatment. Furthermore, the authors present the unusual case of a patient suffering from progressive visual deterioration from a cerebral cavernoma compressing the optic nerve. Results The follow-up period was between 3 and 10 years. All orbital cavernomas in the group of conservatively managed patients remained stable. The transconjunctival excision of a medially located lesion was uncomplicated. The frontotemporal approach was chosen for large tumors situated in the proximity of the orbital apex and was associated with a higher number of complications. A good overall outcome of visual function and patient satisfaction was achieved in 11 of 14 cases operated on by craniotomy. Conclusion The combination of clinical signs and magnetic resonance imaging (MRI) is highly sensitive and specific for the diagnosis of orbital cavernomas. In the presence of visual deterioration clearly attributable to the tumor we recommend immediate surgery, while lesions producing solely exophthalmos can safely be followed by observation. The transcranial approach offers excellent exposure and a rewarding cosmetic result and may be considered for large lesions superior and medial to the optic nerve, especially if they involve the orbital apex. © 2004 Elsevier Inc. All rights reserved. |
| Databáze: | OpenAIRE |
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