ORIGINAL ARTICLE   

European Journal of Oral and Maxillofacial Surgery 2018 August;2(2):30-3

DOI: 10.23736/S2532-3466.18.00138-8

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Cryosurgical treatment for the removal of orbital cavernous hemangiomas: our experience

Simone ULIVIERI ¹, Leonello TACCONI ² ✉, Davide LUGLIETTO ¹, Giuseppe OLIVERI ¹

¹ Department of Neurosurgery, Santa Maria alle Scotte Hospital, Siena, Italy; ² Department of Neurosurgery, Azienda Universitaria Integrata, Trieste, Italy

BACKGROUND: Cavernous hemangioma is a benign vascular malformation which probably represents the most common intraorbital and intraconal tumors in adult. When the lesion is small it can also be followed up, if instead the lesion has reached a considerable size with increasing neurological deficits the surgical removal becomes compulsory. Different approaches have been described to enter the orbit in the literature, nevertheless only a few Centers have reported the use of a cryo-assisted minimally invasive procedure using a cold probe as a traction device for gentle handling of the lesion.
METHODS: We collected a consecutive prospective series of 22 patients operated on for an orbital tumor. Among these we selected 16 patients who had undergone surgery for a cavernous hemangioma. The demographics, the surgical data as well as our result are presented. A method to handle the tumor with a cryoprobe is discussed.
RESULTS: The lesions were removed completely with minimal additional deficits and no intraoperative complications. At a median follow-up of 14 months (range between 5 and 21 months) all the patients have had their deficits settled with no evidence of recurrence tumor.
CONCLUSIONS: Orbital surgery is a subspecialty field that requires high competence and knowledge of this specific anatomical cavity and its structures. It is not simply a matter of removing a mass but doing so with respect to the important nervous and vascular integrity of this area. This is the reason why it is important to make fully use of all available instrumentation and technology. The use of cryo-probe to hold firmly the tumor and the ultrasound guide to locate the mass and the surrounding normal anatomical structures have proved to be very effective and safe.

KEY WORDS: Orbital neoplasms - Cavernous hemangioma - Visual acuity