Recurrent orbital varices after surgical excision with and without prior embolization with n-butyl cyanoacrylate

To report a series of 4 recurrent orbital varices after resection, 2 of which were embolized with cyanoacrylate glue before surgery.

Retrospective case series.

Charts of all patients seen by a single orbital surgeon from January 1986 through June 2013 with presumed or histologically confirmed orbital varix were reviewed retrospectively. Four patients were identified with recurrence of symptoms after resection of the varix, 2 after embolization with n-butyl cyanoacrylate and 2 via a right frontal craniotomy. Each had initial complete resolution of their symptoms followed by recurrence to a lesser degree. Characteristics and common features in each case were reviewed.

After initial resection, these 4 patients had recurrence of their symptoms within 8 months to 12 years. A common feature among them included an active lifestyle involving significant heavy lifting.

Orbital varices may be recurrent, even after n-butyl cyanoacrylate embolization, with repeated Valsalva-type maneuvers.