Ponto, K. A., Brockmann, M. A., Koutsimpelas, D., Heider, J., Ringel, F. A., Heindl, L. M. and Kakassery, V (2021). Excisional surgery of orbital tumors. Ophthalmologe, 118 (10). S. 995 - 1004. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0423

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Abstract

The indications for orbital tumor surgery are an incisional biopsy to confirm the diagnosis or in malignant operable tumors a complete excision or a debulking to avoid complications in large invasively infiltrating tumors. In the case of benign tumors, the indications for surgery depend mostly on the clinical symptoms and cosmetic esthetic disfigurement. In the present article the preoperative examinations as well as surgical access approaches to different orbital regions, endoscopic procedures and methods of intraoperative navigation are presented. Magnetic resonance imaging is the instrument of choice, whereby in many cases computed tomography (CT) adds further information. Depending on the indications, diffusion-weighted sequences, CT angiography and digital subtraction angiography (DSA, catheter angiography) are added to the preoperative diagnostics. For space-occupying lesions located anterior to the bulbar equator, an anterior orbitotomy can be performed transconjunctivally or transpalpebrally. A lateral orbitotomy is used to reach lateral, laterocranial, and lateroinferior orbital segments, whereas transcranial approaches are suitable for processes located far posterior and for those with retro-orbital intracranial extension as well as for processes in the optic foramen/superior orbital fissure. The indications for an endonasal access approach are processes medial to the bulb or optic nerve and up to the orbital apex. A transantral access can be chosen for caudal, mediolateral, and medioinferior space-occupying lesions. Modern orbital surgery is complemented by endoscopic procedures and intraoperative navigation. Orbital tumors belong to the interdisciplinary relevant diseases. Therefore, an optimal management takes place at specialized multidisciplinary centers.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Ponto, K. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brockmann, M. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koutsimpelas, D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heider, J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ringel, F. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heindl, L. M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kakassery, VUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-587151
DOI: 10.1007/s00347-021-01386-5
Journal or Publication Title: Ophthalmologe
Volume: 118
Number: 10
Page Range: S. 995 - 1004
Date: 2021
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1433-0423
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
OphthalmologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/58715

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