Orbital Tumors: Report of 70 Surgically Treated Cases

Nicola Montano, Liverana Lauretti, Quintino Giorgio D'Alessandris, Mario Rigante, Fabrizio Pignotti, Alessandro Olivi, Gaetano Paludetti, Roberto Pallini, Eduardo Fernandez

Research output: Contribution to journalArticle

Abstract

Objective: The orbital cavity is an anatomically complex region and an area of interest of many specialists, each of whom is familiar with specific surgical approaches. Methods: We retrospectively reviewed clinical and outcome data of 70 patients who underwent surgery for resection of an orbital tumor with a mean follow-up of 111.9 ± 79.6 months. The clinical outcome was reported and the role of sex, age, histology, tumor location, tumor size, and surgical approach on the extent of tumor removal was assessed. Results: Total removal was achieved in 74.3%, subtotal removal in 20%, and partial removal in 5.7% of patients. A fronto-orbital craniotomy was used in 57.1% of cases, frontal approach in 17.1%, fronto-orbit-zygomatic approach in 10%, and endoscopic endonasal approach in 11.4%. Complications included visual acuity decrease (4.3%), cerebrospinal fluid leak (4.3%), nerve palsy (10%; supra-orbital nerve 4.3%; frontal branches of facial nerve 2.9%, third cranial nerve 2.9%), and enophthalmos (1.4%). Lateral orbitotomy, combined fronto-orbital and maxillotomy, and trans-eyelid approaches were used in the remaining cases. The fronto-orbital, frontal, and lateral orbitotomy approaches were associated with greater rates of total resection as compared with the fronto-orbit-zygomatic approach, which was used in difficult cases in which the tumor involved several regions. Conclusions: We recommend, 1) the endoscopic endonasal approach for primary orbital tumors located in the medial or inferior orbital walls without extra-orbital extension; 2) the trans-eyelid approach for tumors of the upper and upper-lateral quadrants extraconally located, and 3) the fronto-orbital approach for intraconally located tumors involving more than one quadrant.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

Keywords

  • Endoscopy
  • Fronto-orbital craniotomy
  • Orbital tumors
  • Outcome
  • Prognosis
  • Surgical approach

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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  • Cite this

    Montano, N., Lauretti, L., D'Alessandris, Q. G., Rigante, M., Pignotti, F., Olivi, A., Paludetti, G., Pallini, R., & Fernandez, E. (Accepted/In press). Orbital Tumors: Report of 70 Surgically Treated Cases. World Neurosurgery. https://doi.org/10.1016/j.wneu.2018.07.181