Surgical excision of periorbital capillary hemangiomas.
BACKGROUND
Periorbital capillary hemangiomas of childhood can produce ptosis, strabismus, and anisometropia, resulting in amblyopia. Traditional therapy with either systemic or local corticosteroids occasionally yields incomplete resolution of these lesions and may be associated with numerous adverse complications. The authors report their experience performing surgical resection of periorbital capillary hemangiomas.


METHODS
Twelve children with periorbital capillary hemangiomas were treated surgically. Six of these children had previously failed to adequately respond to steroid injections and six were primarily treated with surgical resection. All lesions were believed to be localized and did not appear to be infiltrative on preoperative computed tomographic scans.


RESULTS
All lesions were completely resected, except for two in which there was a small area of residual hemangioma surrounding the lacrimal drainage system that was left intact. Controlled intraoperative hemorrhage in two patients required intraoperative directed-donor blood transfusion. Perioperatively, in one patient a wound dehiscence developed, which required minor repair. This same patient elected to have surgical scar revision postoperatively. The patients have been followed up to 5 years. All did well with improved cosmesis, and they have good lid function. No recurrences have been noted.


CONCLUSIONS
Surgical resection of pediatric capillary hemangiomas should be considered a treatment option in those that fail to respond to corticosteroids and/or are isolated and noninfiltrative in nature.
Walker
R S
RS
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO.
Custer
P L
PL
Nerad
J A
JA
D001623:Betamethasone / Q000008:administration & dosage; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D018324:Hemangioma, Capillary / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D015552:Injections, Intralesional; D008297:Male; D009918:Orbital Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014221:Triamcinolone / Q000008:administration & dosage
D014221:Triamcinolone; D001623:Betamethasone