Korean J Ophthalmol.  2010 Oct;24(5):274-278. 10.3341/kjo.2010.24.5.274.

Surgical Outcomes of Transconjunctival Anterior Orbitotomy for Intraconal Orbital Cavernous Hemangioma

• Cho KJ
• Paik JS
• Yang SW

• KMID: 974320
• DOI: http://doi.org/10.3341/kjo.2010.24.5.274

Abstract

PURPOSE
To describe surgical outcomes for transconjunctival anterior orbitotomy for intraconal cavernous hemangiomas.
METHODS
The medical records of 9 consecutive patients with intraconal cavernous hemangiomas who underwent surgical removal by transconjunctival anterior orbitotomy were retrospectively reviewed. The conjunctiva was incised and retracted with a traction suture. For large tumors, a rectus muscle was temporarily disinserted. Tenon's capsule was separated and the tumor was removed with a cryoprobe or clamp. Surgical outcomes, positions of the tumors, methods of approach, and intra- and post-operative complications were evaluated.
RESULTS
The mean follow-up period was 33 +/- 6.8 months. No bony orbitotomy was used in this technique and the cosmetic results were very satisfactory. All tumors were removed intact. In 4 patients, tumors were extirpated with the aid of a cryoprobe. No patients had residual proptosis or limitation of ocular movement. No signs of recurrence were noted in any cases at 33 months follow-up. No serious or permanent complications were observed during or after the operation.
CONCLUSIONS
Transconjunctival anterior orbitotomy is an important surgical procedure in the treatment of intraconal cavernous hemangiomas. It can produce an excellent result, even if the posterior border of the tumor abuts the orbital apex.

Keyword

Anterior orbitotomy; Cavernous hemangioma; Cryoprobe

MeSH Terms

Adult
Conjunctiva/pathology/surgery
Female
Follow-Up Studies
Hemangioma, Cavernous/pathology/radiography/*surgery
Humans
Male
Middle Aged
Ophthalmologic Surgical Procedures/*methods
Orbital Neoplasms/pathology/radiography/*surgery
Tomography, X-Ray Computed
Treatment Outcome

Figure

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  Fig. 1 Preoperative computed tomography (CT) and magnetic resonance imaging (MRI). (A) Axial CT (mass is ovoid in shape and sharply delineated). (B) Coronal T2-weighted MRI (intraconal mass at the medial portion of the left orbit). (C) Axial T2-weighted MRI (intraconal mass at the inferolateral portion of the left orbit). (D) Axial T2-weighted MRI (lesion immediately behind the eyeball causing flattening of the globe).

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  Fig. 2 Surgical procedures. (A) Anterior orbitotomy (transconjunctival incision). (B) Extraction of the mass with a cryoprobe. (C,D) Tumor mass (completely encapsulated, dark red or purple in color).

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