Ophthalmological and Interdisciplinary Surgical Approaches to the Orbit

Abstract

The treatment of orbital masses often requires an interdisciplinary approach. Ophthalmological surgical approaches include the anterior transcutaneous approach for removal of dermoids or taking biopsies. Anterior transconjunctival orbitotomy is suitable for masses of the inferior orbit or the intraconal compartment, but is inappropriate for masses of the orbital apex. The lateral transosseous orbitotomy often fits for masses of the lateral or intraconal compartment, especially for neoplasms of the lacrimal gland e.g. pleomorphic adenoma. Cryoextraction is often the technique of first choice for cavernous haemangiomas of all localisations. Transfrontal approaches are suitable for the resection of tumours of the optic nerve and of the orbital apex.

Key words

anatomy - ocular tumors - orbit

Publikationsverlauf

Eingereicht: 11. Mai 2023

Angenommen: 02. August 2023

Artikel online veröffentlicht:
15. November 2023

• References/Literatur

• 1 Shields JA, Shields C, Scartozzi R. Survey of 1264 patients with orbital tumors and simulating lesions: The 2002 Montgomery Lecture, part 1. Ophthalmology 2004; 111: 997-1008
• 2 Das S, Pineda G, Goff L. et al. The eye of the beholder: orbital metastases from midgut neuroendocrine tumors, a two institution experience. Cancer Imaging 2018; 18: 47
• 3 Mombaerts I, Bilyk JR, Rose GE. et al. Consensus on Diagnostic Criteria of Idiopathic Orbital Inflammation Using a Modified Delphi Approach. JAMA Ophthalmol 2017; 135: 769-776
• 4 Welkoborsky HJ, Wiechens B, Hinni ML. Orbita: Interdisziplinäres Management von Orbitaerkrankungen. Stuttgart, New York: Thieme; 2016
• 5 Rose GE. The “devilʼs touch”: visual loss and orbital surgery. A synopsis of the Mustardé Lecture, 2006. Orbit 2007; 26: 147-158
• 6 Tai J, Lai K, Kuk A. et al. Modified vertical lid split orbitotomy: a case series and literature review. Orbit 2023; 42: 181-185
• 7 Font RL, Smith SL, Bryan RG. Malignant Epithelial Tumors of the Lacrimal Gland: A Clinicopathologic Study of 21 Cases. Arch Ophthalmol 1998; 116: 613-616
• 8 Rose GE, Wright JE. Pleomorphic adenoma of the lacrimal gland. Br J Ophthalmol 1992; 76: 395-400
• 9 Ro SR, Asbach P, Siebert E. et al. Characterization of orbital masses by multiparametric MRI. Eur J Radiol 2016; 85: 324-336
• 10 Erb-Eigner K, Asbach P, Ro SR. et al. DCE-MR imaging of orbital lesions: diagnostic performance of the tumor flow residence time τ calculated by a multi-compartmental pharmacokinetic tumor model based on individual factors. Acta Radiol 2019; 60: 643-652
• 11 Li X, Wu X, Qian J. et al. Differentiation of lacrimal gland tumors using the multi-model MRI: classification and regression tree (CART)-based analysis. Acta Radiol 2022; 63: 923-932
• 12 Lazar M, Rosen N, Geyer O. et al. A transconjunctival cryosurgical approach for intraorbital tumours. Aust N Z J Ophthalmol 1985; 13: 417-420
• 13 Locatelli D, Dallan I, Castelnuovo P. Surgery around the Orbit: How to Select an Approach. J Neurol Surg B Skull Base 2020; 81: 409-421
• 14 Rosen N, Priel A, Simon GJ. et al. Cryo-assisted anterior approach for surgery of retroocular orbital tumours avoids the need for lateral or transcranial orbitotomy in most cases. Acta Ophthalmol 2010; 88: 675-680
• 15 Seiichiro M, Yoshinori H, Kentaro H. et al. Superolateral Orbitotomy for Intraorbital Tumors: Comparison with the Conventional Approach. J Neurol Surg B Skull Base 2016; 77: 473-478
• 16 Zipfel J, Tellermann J, Besch D. et al. Surgical Management of Pre-Chiasmatic Intraorbital Optic Nerve Gliomas in Children after Loss of Visual Function-Resection from Bulbus to Chiasm. Children (Basel) 2022; 9: 459