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