ORIGINAL ARTICLES   

Otorinolaringologia 2001 September;51(3):111-8

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Proptosis: otolaryngologist point of view

Gupta A. K., Bakshi J., Man S. B. S.

From the Department of Otorhinolaryngology Postgraduate Institute of Medical Education & Research, Chandigarh, India

Back­ground. The ­study was under­taken to ­find var­ious ­lesions pre­senting as prop­tosis and to ­study ­their man­age­ment pro­to­cols ­from the ­otolaryngologist’s ­point of ­view.
­Methods. Experi­mental ­design: ­this ­study was con­ducted ­from 1994 to 2000 in ­which all ­cases of prop­tosis who pre­sented to ENT and ­Head and ­Neck Sur­gery OPD ­were ­included. Set­tings: ­this ­study was car­ried out at Post­grad­uate Insti­tute of Med­ical & ­Research, Chan­di­garh (­India) ­which is a ter­tiary ­care hos­pital. ­Patients: ­total 27 ­patients ­with prop­tosis ­were ­included in the ­study. 98% of the ­patients ­belonged to ­poor ­socio-eco­nomic ­class. 8 ­cases had prop­tosis due to ­tumours of the ­orbit, 5 ­cases had ­fungal gra­nu­loma of the ­orbit, 4 had der­moid ­cysts, 4 had ­arterio-­venous mal­for­ma­tion (­AVMS) in the ­orbit and one ­each had lac­rimal sac muco­cele, ­orbital pseu­do­lym­phoma ­hydatid ­cyst and hamar­toma of the ­orbit. Meas­ures: sur­gery was con­sid­ered to be the treat­ment of ­choice for ­benign ­tumors ­with prop­tosis. It has to be com­bined ­with radio­therapy and/or chem­o­therapy for malig­nant ­tumors. For ­cases ­with ­fungal gra­nu­loma ­invading the ­orbital tis­sues and ­optic ­nerve, ­oral itra­con­a­zole (­dose 200 mg ­twice ­daily) for 4-6 ­months was ­found to be effec­tive.
­Results. ­Single ­stage sur­gical pro­ce­dures ­were ­used in 22 ­cases. One ­case ­with ade­noid ­cystic car­ci­noma and the ­other ­with recur­rent ­AVMS ­needed ­second sur­gery for recur­rent dis­ease. No mor­tality was ­found ­during 5 ­years ­follow-up.
Con­clu­sions. The ­results of ­this ­study are encour­aging and ­show ­that an otol­a­ryn­gol­o­gist ­plays a ­vital ­role in the man­age­ment of ­such ­cases.