Combined surgical method of orbital and periorbital hemangioma treatment in infants

Orbit. 2008;27(4):249-57. doi: 10.1080/01676830802250101.

Abstract

Purpose: To analyze the results of application of combined surgical treatment in different forms of hemangioma in infants.

Materials and methods: One hundred seventy-four children with different forms of orbital and periorbital hemangiomas aged 1-16 months (mean age 5.2 + 1.97 months) were operated on at the pediatric ophthalmology department. Fast growth of hemangioma, both superficial (intradermal) and deep (subdermal and orbital) localization, significant deformity of eyelids, with narrowing of eye fissure were the indications for surgical treatment. The combined-staged method, including cryosurgery of superficial intradermal lesions and surgical excision of subdermal and/or orbital parts of the tumor in different combinations depending on the form and depth of hemangioma spreading, was applied.

Results: Usage of cryodestruction usually on the first stage of treatment allowed gentle scarring of the angiomatously changed skin areas. Surgical excision of the deep part of the tumor eliminated disfigurement and visual axis occlusion, avoiding amblyopia development. Good cosmetic and anatomic result was achieved in 90.4% of cases.

Conclusion: Combined surgical method of treatment of progressive capillary hemangiomas by using cryosurgery and surgical excision in infants allows the choice of optimum tactics depending on features of the course and clinical picture in each individual case and provides achievement of high cosmetic and functional result of treatment. The early beginning of treatment in cases of fast progressing of the tumor allows prevention of extensive skin affection and amblyopia development.

MeSH terms

  • Cryosurgery
  • Eyelid Neoplasms / diagnostic imaging
  • Eyelid Neoplasms / pathology
  • Eyelid Neoplasms / surgery*
  • Hemangioma, Capillary / diagnostic imaging
  • Hemangioma, Capillary / pathology
  • Hemangioma, Capillary / surgery*
  • Humans
  • Infant
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Ophthalmologic Surgical Procedures
  • Orbital Neoplasms / diagnostic imaging
  • Orbital Neoplasms / pathology
  • Orbital Neoplasms / surgery*
  • Skin Neoplasms / diagnostic imaging
  • Skin Neoplasms / pathology
  • Skin Neoplasms / surgery*
  • Tomography, X-Ray Computed