Combined surgical method of orbital and periorbital hemangioma treatment in infants
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Svetlana A Tronina1, Nadiya F Bobrova, Valentina P Khrinenko
1The Filatov Institute of Eye Diseases and Tissue Therapy, Odessa, Ukraine. svetlanatronina@mail.ru
Insights
A combined surgical approach using cryosurgery and excision effectively treats infantile hemangiomas, achieving excellent cosmetic and functional outcomes. Early intervention in progressive cases prevents disfigurement and vision loss.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Dermatology
Background:
- Infantile hemangiomas are common benign vascular tumors.
- Orbital and periorbital hemangiomas can cause significant cosmetic deformities and functional impairment, including visual axis occlusion.
- Surgical intervention is indicated for rapidly growing or functionally significant lesions.
Purpose of the Study:
- To evaluate the efficacy of a combined surgical treatment for various forms of infantile hemangiomas.
- To analyze the cosmetic and functional outcomes of this combined approach.
Main Methods:
- A retrospective analysis of 174 infants (aged 1-16 months) with orbital and periorbital hemangiomas.
- A combined-staged surgical method involving cryosurgery for superficial lesions and surgical excision for deep components.
- Treatment tailored to hemangioma type, depth, and spread.
Main Results:
- Combined treatment resulted in good cosmetic and anatomical outcomes in 90.4% of cases.
- Cryosurgery facilitated gentle scarring of superficial lesions.
- Surgical excision effectively addressed deep tumors, preventing disfigurement and amblyopia.
Conclusions:
- The combined surgical method offers optimal, individualized treatment for infantile hemangiomas.
- This approach achieves high cosmetic and functional results.
- Early treatment is crucial for preventing severe skin damage and amblyopia.
Purpose:
To analyze the results of application of combined surgical treatment in different forms of hemangioma in infants.
Materials And Methods:
One hundred seventy-four children with different forms of orbital and periorbital hemangiomas aged 1-16 months (mean age 5.2 + 1.97 months) were operated on at the pediatric ophthalmology department. Fast growth of hemangioma, both superficial (intradermal) and deep (subdermal and orbital) localization, significant deformity of eyelids, with narrowing of eye fissure were the indications for surgical treatment. The combined-staged method, including cryosurgery of superficial intradermal lesions and surgical excision of subdermal and/or orbital parts of the tumor in different combinations depending on the form and depth of hemangioma spreading, was applied.
Results:
Usage of cryodestruction usually on the first stage of treatment allowed gentle scarring of the angiomatously changed skin areas. Surgical excision of the deep part of the tumor eliminated disfigurement and visual axis occlusion, avoiding amblyopia development. Good cosmetic and anatomic result was achieved in 90.4% of cases.
Conclusion:
Combined surgical method of treatment of progressive capillary hemangiomas by using cryosurgery and surgical excision in infants allows the choice of optimum tactics depending on features of the course and clinical picture in each individual case and provides achievement of high cosmetic and functional result of treatment. The early beginning of treatment in cases of fast progressing of the tumor allows prevention of extensive skin affection and amblyopia development.
