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Orbital Tumors Excision without Bony Marginotomy under Local and General Anesthesia
Robert A Goldberg1, Daniel B Rootman1, Nariman Nassiri1
1Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, 100 Stein Plaza, Los Angeles, CA 90095, USA.
Journal of Ophthalmology
|May 16, 2014
Summary
Minimally invasive soft tissue approaches effectively remove deep orbital tumors, often under local anesthesia. These techniques offer safe and successful tumor excision with good visual outcomes and no recurrence.
Area of Science:
- Ophthalmology
- Neurosurgery
- Surgical Oncology
Background:
- Orbital tumors, particularly those in the middle to deep regions, present surgical challenges.
- Traditional approaches may involve significant morbidity and extended operating times.
Purpose of the Study:
- To evaluate the efficacy and safety of minimally invasive soft tissue approaches for removing middle to deep orbital tumors.
- To assess the feasibility of performing these procedures under local anesthesia.
Main Methods:
- A retrospective case series of 30 patients undergoing orbital tumor removal.
- Tumors were accessed via eyelid crease, conjunctival, lateral canthal, or transcaruncular approaches.
- Procedures were performed under local anesthesia with monitored anesthesia care or general anesthesia.
Main Results:
- Tumor pathologies included cavernous hemangioma, pleomorphic adenoma, solitary fibrous tumor, neurofibroma, schwannoma, and orbital varix.
- All patients, except one, maintained or improved visual acuity and ocular motility post-surgery.
- No tumor recurrence was observed during the follow-up period.
Conclusions:
- Minimally invasive soft tissue incisions can safely and effectively remove benign orbital tumors without the need for bone removal.
- These approaches can reduce operative time and morbidity compared to traditional methods.
- Local anesthesia is a viable option for selected deep orbital tumor removals.
