Periocular hemangiomas in childhood – functional and esthetic results

Abstract

Periorbital hemangiomas must be managed by individual and interdisciplinary diagnostic and therapeutic approaches. Therapy of amblyopia remains mandatory in all cases of large eyelid hemangiomas and/or orbital involvement.

Orbit and eyelid hemangiomas: Is there a relationship between location and ocular problems?

“…5,6 During follow-up, visual acuity was measured using fixation preference or standard recognition tests, depending on the patient's age and cooperation. Up to the age of 6 months, ocular examination was performed every 3 to 6 weeks, similar to Sterker and Grafe, 8 who reported an evaluation of refractive error every sixth week. All refractive errors were assessed on the basis of cycloplegic refraction, which was performed by instilling one drop of 0.5% cyclopentolate hydrochloride and one drop of 1% phenylephrine for infants younger than 5 months of age.…”

Combined Surgical Method of Orbital and Periorbital Hemangioma Treatment in Infants

“…Systemic and local application are used for preventing further tumor growth as well as accelerating involution of both superficial and deep hemangiomas (O'Keefe et al, 2003;Orawiec et al, 1996;Pope et al, 2007;Sterker & Grafe, 2004;Verma & Verma, 2001). Besides, if intralesional injection in superficial hemangioma is not technically difficult and not dangerous in deep and, especially, in intraorbital hemangioma localization, it is associated with a possibility of development of complications right up to the loss of vision due to embolization of the corticosteroid particles into the ocular circulation from retrograde arterial flow (Egbert et al, 2001).…”

“…While small-sized intradermal hemangiomas, forming the so-called typical "strawberry nevi," represent exclusively cosmetic defect, extensive lesions of subdermal and intraorbital localization, which cause secondary blepharoptosis, deformation of the palpebral fissure, and, as a consequence, occlusion of the visual axis, can become the cause of amblyopia, astigmatism, and anisometropia development (Grafe, 2004;Hastings et al, 1997;Ranchod et al, 2005;Sterker & Momtchilova et al, 2004).…”

“…At present, conservative methods of treatmentsystemic and local corticosteroid therapy, application of alpha-interferon, radiation therapy (Coats et al, 2003;Egbert et al, 2001;George et al, 2004;Hastings et al, 1997;Neumann et al, 1997;O'Keefe et al, 2003;Pope et al, 2007;Verma & Verma, 2001), as well as surgical methods-excision of the tumor, cryosurgery, and laser surgery (Burstein et al, 2000;Bassukas et al, 2000;Demiri et al, 2001;Levi et al, 2007;Mulliken et al, 2002;Reischle & Schuller-Petrovic, 2000;Sterker & Grafe, 2004;Williams et al, 2000) are applied in hemangioma treatment in children separately and in combinations. Hemangioma treatment pursues two purposeselimination of the amblyogenic factor and cosmetic disfiguration of the child.…”

Magnetic resonance imaging of orbital tumors

“…Rare findings include capillary hemangiomas, lymphomas, and metastases ( Fig. 12) [50]. The majority of benign tumors normally do not undergo imaging evaluation.…”