J Rhinol.  2022 Mar;29(1):48-51. 10.18787/jr.2021.00373.

Removal of Traumatic Hematic Cyst of the Orbit Through Sub-Brow Approach

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

Abstract

Orbital hematic cyst is characterized by cystic accumulation of hematogenous debris surrounded by a wall of fibrous tissue without an epithelial lining. It is a relatively uncommon benign cyst and occurs secondary to blunt trauma in most cases. We experienced a case of 53-year-old male who presented with proptosis of the left eye. A cystic lesion was found at the superolateral orbital rim of the patient. We report a case of orbital hematic cyst that was resected completely through the sub-brow approach.

Keyword

Hematic cyst; Incision below eyebrow; Orbit

Figure

  • Fig. 1. Preoperative facial photos. A: Frontal view of preoperative facial photo. B: Lateral view of preoperative facial photo.

  • Fig. 2. Preoperative radiological imaging. A: Coronal view of contrast computed tomography (CT) scan represents about 2 cm-sized cyst was pressing down the superior rectus muscle inferomedially. B: Axial view of contrast CT shows that non-enhancing cyst was extending to intraconal space of the orbit. C: In T2-weighted magnetic resonance imaging (MRI) scan, a cyst which originated from superolateral orbital rim showed internal high signal density. D: In contrast-enhanced T1-weighted MRI scan, well enhancing lesion was identified.

  • Fig. 3. Intraoperative findings. A: Sub-brow incision line was drawn (arrow). B: Upper portion of the orbital rim was exposed by sub-brow incision. C: Yellowish non-epithelial contents of the orbital hematic cyst was identified (arrow).

  • Fig. 4. Pathologic findings. A: Cholesterol clefts (arrow) due to lipid-laden macrophages. Yellow-brownish crystalloid materials suggesting old hemorrhage (Original magnification ×100, hematoxylin and eosin). B: Collections of red blood cells without vascular lining surrounded by formation of fibrous tissues (Original magnification ×300, hematoxylin and eosin).


Reference

References

1. Kim UR, Arora V, Shah AD, Solanki U. Clinical features and management of posttraumatic subperiosteal hematoma of the orbit. Indian J Ophthalmol. 2011; 59(1):55–8.
Article
2. Yoshikawa K, Fujisawa H, Kajiwara K, Fujii M, Kato S, Akimura T, et al. Cause of hematic cysts of the orbit: increased fibrinolysis and immunohistologic expression of tissue plasminogen activator. Ophthalmology. 2009; 116(1):130–4.
Article
3. Seigel RS, Williams AG, Hutchison JW, Wolter JR, Carlow TJ, Rogers DE. Subperiosteal hematomas of the orbit: angiographic and computed tomographic diagnosis. Radiology. 1982; 143(3):711–4.
Article
4. Friedberg MH, David O, Woog J, Heilman CB. Orbital hematic cyst: case report and clarification of terms. Skull Base Surg. 1997; 7(2):95–9.
Article
5. Bartlett SP, Lin KY, Grossman R, Katowitz J. The surgical management of orbitofacial dermoids in the pediatric patient. Plast Reconstr Surg. 1993; 91(7):1208–15.
Article
6. Devars du Mayne M, Moya-Plana A, Malinvaud D, Laccourreye O, Bonfils P. Sinus mucocele: natural history and long-term recurrence rate. Eur Ann Otorhinolaryngol Head Neck Dis. 2012; 129(3):125–30.
Article
7. Pryor SG, Lewis JE, Weaver AL, Orvidas LJ. Pediatric dermoid cysts of the head and neck. Otolaryngol Head Neck Surg. 2005; 132(6):938–42.
Article
8. Kaufman LM, Villablanca JP, Mafee MF. Diagnostic imaging of cystic lesions in the child’s orbit. Radiol Clin North Am. 1998; 36(6):1149–63.
Article
9. Yazici B, Gönen T. Posttraumatic subperiosteal hematomas of the orbit in children. Ophthalmic Plast Reconstr Surg. 2011; 27(1):33–7.
Article
10. McNab AA. Nontraumatic orbital hemorrhage. Surv Ophthalmol. 2014; 59(2):166–84.
Article
11. Glavas I, Lissauer B, Hornblass A. Chronic subperiosteal hematic cyst formation twelve years after orbital fracture repair with alloplastic orbital floor implant. Orbit. 2005; 24(1):47–9.
Article
12. Cameron JD, Letson RD, Summers CG. Clinical significance of hematic cyst of the orbit. Ophthalmic Plast Reconstr Surg. 1988; 4(2):95–9.
Article
13. Iwata A, Matsumoto T, Mase M, Yamada K. Chronic, traumatic intraconal hematic cyst of the orbit removed through the fronto-orbital approach--case report. Neurol Med Chir (Tokyo). 2000; 40(2):106–9.
14. Krohel GB, Wright JE. Orbital hemorrhage. Am J Ophthalmol. 1979; 88(2):254–8.
Article
15. Nelson KE, Mishra A, Duncan C. Upper blepharoplasty approach to frontozygomatic dermoid cysts. J Craniofac Surg. 2011; 22(6):e41. –4.
Article
Full Text Links
  • JR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr