Authored by OI Lystratenko*
Abstract
Introduction: The article reviews and analyzes the results of treatment of 32 patients with orbital tumors operated in the clinic, neurosurgery until the period from 2015 till September 2019.
Goals and objectives: coverage of clinical signs and symptoms, histology, diagnostic methods and treatment of patients operated on with orbital tumors during the period 2015-2019. Determination of optimal surgical approach to the tumors with different localization for performing the radical organ-preserving surgery, with maximal saving of visual functions, minimization of oculomotor disorders, patient disability.
Materials and methods: we analyzed the clinical cases of 32 patients undergoing treatment in DOKTMO with orbital tumors for the period from 2015 till September 2019.
Results: Patients were operated on with various approaches - transcutaneous, subconjunctive (without orbitotomy), fronto-orbito-zygomatic, pterional, subfrontal (neurosurgical approaches), transmaxillary, transethmoidal (ENT approaches). The choice of surgical approaches were individual. In 2 cases we become a backset of tumor growth: one patient with aggressive adenocarcinoma, after 18 months, leading to orbital exentration and the child, 9 years old with rhabdomyosarcoma after non-radical removal of tumors of subconjunctival approach. In all other cases, relapses were not detected, operation were organ-preserving oriented.
Conclusion: the results of treatment of patients with tumors directly depend on the choice of radicality tumor removal, which is associated with the choice of surgical approach, chemical, radiation treatment in postoperative period depending on the histological response. From our point of view, the most universal method for tumor removal with various localizations and sizes is fronto-orbito-zygomatic approach which provides the performance of radical organ-preserving operation with maximal vision saving, minimizing oculomotor disorders, disability of the patient, despite its technical complexity for ophthalmologist surgeons. In this regard, surgery of orbital tumors is subject to the competence of doctors of related specialties.
Keywords: Orbital tumor; Ptosis; Fronto-orbito-zygomatic approach; Subconjuctive approach; Rhabdomyosarcoma
Introduction
Tumors of the orbit is a common disease among ophthalmic pathology - up to 4%. As it turned out, their diagnosis is a big problem not only for the ophthalmologist. Due to the anatomical proximity of the orbit to the cranial cavities and paranasal sinuses tumors of the orbit are very diverse, as they can arise from different anatomical structures of the orbit. In this regard not only oculists, but also ENT- doctors, maxillofacial surgeons and neurosurgeons can be involved in the diagnosis establishing and delivery of the surgical care of patients with orbital tumors.
The detection of orbital tumors in the Donetsk region since January 2015 has become much higher due to the use of the following examination algorithm:
examination by an ophthalmologist, ENT specialist, neurologist;
Ultrasound of the eye as a screening study;
CT scan with intravenous contrast, MRI to clarify the abundance of the process.
In the article we examined the results of the treatment of 32 patients operated on by us and performed the analysis of the surgical approaches depending on the localization and the nature of the process. We have proposed a scheme for determining the choice of surgical access, affecting on the radical removal of the tumor while maintaining all eye functions.
Materials and Methods
For the period from 2015 till September 2019, in Donetsk Neurosurgergical Clinic, we operated on 32 patients with tumors of the orbit of various localization and histostructure. Among the patients, 15 men (46.9%) and 17 (53.1%) women aged 2 to 79 years. Among them 7 (21.9%) children - 3 boys and 4 girls.
The main symptoms of orbital tumors are: unilateral ptosis, exophthalm, diplopia, progressive decrease in vision in one eye, eye pain.
All patients were examined according to the algorithm above.
To read more about this article..Open access Journal of Neurology & Neuroscience
Please follow the URL to access more information about this article
https://irispublishers.com/ann/fulltext/Diagnosis-and-Surgical-Treatment-of-Orbital.ID.000652.php
To know more about our Journals....Iris Publishers
No comments:
Post a Comment