Title: Orbital Tumours: An Overview of Surgical Management and Histopathology

Authors: Rajeev M P, Pavithran V M, Unnikrishnan E P

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i6.19

Abstract

Introduction: Orbital tumours represent a diverse spectrum in their histopathological nature. Vast arrays of lesions occur in the orbit and merit a systematic work up. The management options depend on the location of the tumour, radiological features and the probable pathology of the lesion.

Materials and Methods: Orbital tumours presented to a tertiary care centre from January 2010 to December 2016 were evaluated retrospectively. There were a total of 28 patients. Hospital records, Outpatient Department Registers, and Records from Department of Radiology were the sources of data collection. Presumptive pre-operative diagnosis was based on Computed Tomography and Magnetic Resonance Imaging findings. Different surgical approaches employed include Superior orbitotomy, Lateral orbitotomy, and Pterional craniotomy depending upon the location of tumour.

Results: The presenting complaints in most cases were proptosis (89%).Other symptoms were decreased vision (53.5 %), diplopia (28%), pain (1.2%) and lacrimation (0.8%). Histopathological findings showed 82% benign tumours and 18% malignant tumours. Schwannoma was the commonest (26%) among benign tumours. Visual acuity improved in 72% of cases and remained the same as preoperative in 28%. A recurrence rate of 14.29% is present in our series. Adjuvant therapy was started in the malignant lesions.

Conclusion: The best strategy for managing orbital tumours is largely determined by the location, size and extends of the lesion. Careful evaluation with history and physical examination along with modern imaging studies provide invaluable information regarding the possible origin of an orbital lesion. Definitive surgical treatment remains the mainstay of therapy for the majority of orbital tumours.

Keywords: Orbital tumour, proptosis, orbitotomy

References

  1. Rhoton Jr AL. The orbit. Neurosurgery. 2002; 51:S303-S334.
  2. Winn H: Youman and Winn Neurological Surgery :7th ed Elsevier
  3. Alfredo Quinones-Hinojosa: Schmidek and Sweet: Operative Neurosurgical Techniques: 6th edition Elsevier
  4. Hyun joon Park,Seung-Ho Yang,Il Sup Kim, Jae Hoon Sung,Byung Chul,Sang Won Lee (2008) Surgical Treatment of Orbital at a Single Institution,J Korean Neurosurg Soc 44.3:146-150
  5. Ravi Ramamurthy,K sridhar,M C Vasudevan. Textbook of Operative Neurosurgery: Surgical approaches to the orbit,page 574,chapter70
  6. Maroon JC: Orbital involvement bytumors: types, recognition and treatment. Contemp Neurosurgery 7:1,1979
  7. McNab AA: Extracranial orbital decompression for optic Neuropathy in Graves’ disease. J Clin Neurosci:186,1998
  8. Alvord EC Jr.,Lofton S:Gliomas of the optic nerve or chiasm: Outcomes by patient’s age, tumour site and treatment. J Neurosurg 68:85,1988
  9. Kronlein RU: Zur Pathologie and operativen behandlung der Dermoidcysten der Orbita. Bruns Beitr Klin Chir 4:149,1888
  10. Winn H: Youman and Winn Neurological Surgery :7th ed Elsevier p161,chap7
  11. Tandon, Prakash Narayan, Ramamurthy, Ravi. Ramamurthy and Tandon’s Textbook of Neurosurgery, 3rd Edition, p 2033.

Corresponding Author

Unnikrishnan E P

Asst Professor, Dept of Neurosurgery, Govt Medical College, Kozhikode, Kerala India Pin 673008

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