[Modified transcranial orbitotomy for treating exophthalmic intraorbital tumor].
OBJECTIVE
To study the feasibility of the modified osteotomy of transcranial orbitotomy in the treatment of intraorbital tumor.


METHODS
We treated 8 patients with intraorbital tumor during six years. By the bicoronary incision, all cases underwent double bone flap osteotomy on the frontal bone: the superior orbital rim bone flap and roof flap instead of single fronto-orbital bone flap in the conventional transcranial orbitotomy. After removal of bone flaps, intracranial and intraorbital operation was performed. Then, two bone flaps were reduced respectively and fixated with titanic micro-plates and nails. At last, the scalp flap was sutured.


RESULTS
The operative field was very well exposed. It was found that the retrobulbar tumor was located at the superolateral, median and superonasal area respectively, which was coincided with the preoperative CT and MRI. The tumor included adenocarcinoma of the lacrimal gland, neurinoma, meningioma, and cavernous hemangioma. Four patients had blood transfusion during the operation. No other postoperative complications happened except 3 cases of diplopia and one case of blindness. After 3 to 6 months follow up, diplopia of the 3 cases gradually disappeared. Of the 8 cases, 6 reached the same visual acuity as the preoperative state. One decreased visual acuity and one lost light perception. There was well-balanced fronto-orbital appearance and eyeball position compared with the healthy side in all cases.


CONCLUSIONS
This surgical method for the treatment of intraorbital tumor is safe with well-exposed operative field. It has advantages not only in simpleness and less trauma, but also in keeping orbital roof and anterior fossa intact and decreasing complications.
Ye
Xin-hai
XH
Department of Plastic Surgery, The Eye Hospital, Wenzhou Medical College, China.
Zhou
Sheng-jie
SJ
Chen
Xi
X
Wang
Kai-yuan
KY
Wang
Qin-mei
QM
Qu
Jia
J
D000328:Adult; D003399:Craniotomy / Q000379:methods*; D005094:Exophthalmos / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D009915:Orbit / Q000601:surgery; D009918:Orbital Neoplasms / Q000601:surgery*; D013524:Surgical Flaps; D055815:Young Adult