209例眼眶海绵状血管瘤的诊断和手术治疗

目的探讨眼眶海绵状血管瘤的临床特点、术前定性诊断与手术入路选择。方法对1986至2000年在中山大学中山眼科中心住院的眼眶海绵状血管瘤患者进行回顾性分析。结果209例中,男86例,女123例;右眼86例,左眼123例;年龄5～68岁,平均39,2岁;以渐进性眼球突出和视力下降为主要临床表现。95％（199／209）根据超声波和CT或MRI可作出术前准确诊断。64％（134／209）采用前路开眶,36％（75／209）采用外侧开眶顺利摘除肿物。结论眼眶海绵状血管瘤术前基本上可作出诊断,约2／3的病例不需外侧开眶即可顺利摘除肿物,术后并发症少。

Diagnosis and surgical management of 209 cases of orbital cavernous hemangioma

Objective To study the clinical features,preoperative diagnosis and surgical choice of orbital cavernous hemangioma.Methods Records of all cavernous hemangioma patients(209 cases) who were seen in Eye Hospital,Zhongshan Ophthalmic Center,Sun Yat-sen University from January 1,1986 to December 31,2000 were reviewed.Results Among 209 cases,123 patients were females and 86 were males.The left orbit was affected in 123 cases and the right orbit in 86 cases.No case was bilaterally involved.The mean age was 39.2 years old,ranging from 5 to 68 years.A painless,gradually progressive proptosis and visual disturbance were the main clinical signs.Ninety-five percent(199/209) of them could be accurately diagnosed preoperatively based on ultrasound scan and CT/MRI examination.The tumors were removed successfully by the surgical procedure of standard lateral orbitotomy in 36%(75/209) of patients and anterior orbitotomy in 64% cases(134/209).Conclusions Nearly all patients with cavernous hemangioma could be correctly diagnosed by preoperative image studying.The simple surgical procedure of anterior orbitotomy can be successfully used in about two third of cases with less surgical complication.