Prise en charge des hémangiomes caverneux orbitaires – évaluation des voies d’abord chirurgicales : à propos de 43 cas

Aymard, Pierre-Antoine; Langlois, B; Putterman, Miriam; Jacomet, P.V.; Morax, S; Galatoire, O.

doi:10.1016/j.jfo.2013.04.009

Cited by 16 publications

(4 citation statements)

References 11 publications

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“…Although major mydriasis has been reported in 3%–7% of OCVM excisions (Table 4), 3–10 this is likely to underestimate the true incidence of PEPAs, as this study has shown that many are mild (only visible on slit-lamp biomicroscopy) or very transient. Our higher overall incidence of PEPAs (21%) is probably a more accurate estimate as it includes both fleeting anomalies and minor changes recorded at the slit-lamp examination.…”

Section: Discussionmentioning

confidence: 81%

“…1–3 It can be temporary or permanent and is thought to result from iatrogenic compression or disruption of the parasympathetic fibers within the inferior division of the oculomotor nerve or ciliary ganglion. 2 Frank mydriasis has been reported in up to 7% of patients after excision of orbital cavernous venous malformations (OCVMs) 3–10 ; this might, however, be a significant underestimate of postoperative efferent pupillary abnormalities (PEPAs) as, in many cases, there is only minor and transient sectoral paresis or vermiform contraction—evident only on careful slit-lamp examination.…”

mentioning

confidence: 99%

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Pupillary Abnormalities After Excision of Orbital Cavernous Venous Malformations

Vahdani

Rose

2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Aims: The aim of this study was to determine the incidence and recovery rate for pupillary abnormalities after excision of orbital cavernous venous malformations (OCVMs). Methods: Retrospective case-note and imaging review for patients with OCVMs, with an estimation of odds ratios (ORs) in relation to the position of the mass and surgical approach. Results: The 287 included patients (176 female; 61%) presented at a mean age of 46.5 years: 243/287 (85%) OCVMs were intraconal, 253/287 (88%) located in the posterior two-thirds of the orbit, and 29/287 (11%) wedged tightly in the apex. Pupillary changes—varying from minor sectoral paresis (only evident on slit-lamp examination) to a marked mydriasis—were noted in 21% (60/287) of patients and were strongly associated with removal of intraconal (60/243 [25%]; p < 0.001), apical (14/29 [48%]; OR, 4.3; p < 0.001), inferior or inferotemporal (41/105 [39%]; OR, 5.5; p < 0.001) masses. Lateral approaches—either with (23/129; 18%) or without (30/71; 42%) osteotomy—were associated with 88% (53/60) of all abnormalities (OR, 4.1; p < 0.001). Where known, the abnormalities improved in 43/50 (86%), although 15/43 (35%) had a persistent tonic pupil. Conclusion: Pupillary abnormalities after excision of OCVMs can occur in up to a quarter of intraconal lesions—particularly those located inferotemporally or inferiorly—and in about a half of apical lesions. Lateral or inferolateral orbital approaches that disrupt the inferior intraconal fat appear to be associated with a higher risk. Most changes resolve or improve markedly, although a third of those affected may have a persistent tonic pupil.

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Section: Discussionmentioning

confidence: 81%

mentioning

confidence: 99%

Pupillary Abnormalities After Excision of Orbital Cavernous Venous Malformations

Vahdani

Rose

2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…Передняя орбитотомия часто используется как при интракональных, так и при экстракональных поражениях, исключая поражения в области верхушки орбиты, что составляет почти 60% случаев [18][19][20]. При использовании трансконъюнктивального доступа после вскрытия конъюнктивы и фиксации экстраокулярных мышц накладываются швы шелковой нитью рядом с местом прикрепления мышц для ретракции глазного яблока от каверномы [19,21].…”

Section: Discussionunclassified

The transpalpebral keyhole approach in surgery of orbital cavernomas: a case report and literature review

Rs¹,

On²,

Va³

et al. 2018

Vopr. neirokhir.

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“…[19], половина случаев КапГО размером более 1 см является важным предиктором потери зрения и требует лечения, в том числе хирургического. При КГО хирургическое вмешательство проводится примерно в 50% наблюдений [20][21][22][23][24].…”

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Orbital hemangiomas: capabilities of modern neuroradiological diagnostics

Shchurova

Pronin

Melnikova-Pitskhelauri

et al. 2018

Vopr. neirokhir.

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Modern CT- and MRI-based diagnostics of orbital hemangiomas provides not only the exact location, size, and spread of the lesion but also reveals the characteristic structural features of these tumors, and the use of perfusion techniques visualizes hemodynamics of the tumors. CT-perfusion-based hemodynamic parameters of cavernous hemangiomas typical of this type of hemangiomas may be used in the differential diagnosis with other tumors of this location. The use of contrast enhancement and the Fat Sat technique with a scan thickness of not more than 3 mm is optimal for MRI diagnostics of orbital hemangiomas.

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Prise en charge des hémangiomes caverneux orbitaires – évaluation des voies d’abord chirurgicales : à propos de 43 cas

Cited by 16 publications

References 11 publications

Pupillary Abnormalities After Excision of Orbital Cavernous Venous Malformations

Pupillary Abnormalities After Excision of Orbital Cavernous Venous Malformations

The transpalpebral keyhole approach in surgery of orbital cavernomas: a case report and literature review

Orbital hemangiomas: capabilities of modern neuroradiological diagnostics

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