眼眶神经鞘瘤30例分析

目的总结分析１９８５～１９９４年在我院经病理证实的孤立性眼眶神经鞘瘤。方法回顾性研究３０例孤立性眼眶神经鞘瘤的临床特点、诊断要点及治疗方法。对不同手术方法的术后并发症及术后复发情况进行了对比。结果孤立性眼眶神经鞘瘤多见于２０～４０岁青壮年，男女患病率差异无显著性。多表现为眼球突出，可伴有视力下降、眼部疼痛、眼球活动受限等。均行手术摘除肿瘤。术后视力下降８例（２６．７％），不变１３例（４３．３％），提高９例（３０．０％）；早期上睑下垂８例（２６．７％），眼球活动受限１１例（３６．７％）。术后随访１．５～１０．０年，５例复发，其中１例为低度恶性，４例为良性。大部分上睑下垂及眼球运动受限者，术后３～６个月恢复正常。结论应根据肿瘤的发生部位，选择最佳手术进路。

An analysis on 30 cases of orbital schwannomas

OBJECTIVE: To study isolated orbital schwannomas confirmed histopathologically in our hospital between 1985 and 1994. METHODS: The clinical features, diagnosis and treatment of 30 cases with the tumor were retrospectively studied. The postoperative complications and clinical recurrences after different surgical approaches were compared. RESULTS: Isolated orbital schwannoma occurs most commonly at the age of 20-40. The sex incidence is similar. Most of the patients complained of proptosis, some of them were accompanied by blurred vision, ocular pain, restricted ocular movement, etc. The tumors were resected surgically. In comparison with pre-operative visual acuity, the postoperative visual acuity was worse in 8 cases (26.7%), similar in 13 cases (43.3%), and improved in 9 cases (30.0%). There were early ptosis of the eyelid in 8 cases (26.7%) and restricted eye movement in 11 cases (36.7%). In 1.5-10 years of follow-up, clinical recurrences in 5 cases, one malignant and four benign, were seen. Most of the ptosis and restricted eye movement recovered after 3-6 months. CONCLUSION: According to the location of the tumor, the best surgical approach should be selected.