title: Lymphatic malformations of the orbit.
abstract: OBJECTIVE
  Lymphatic malformations of the orbit are rare lesions that constitute approximately 1% to 8% of all orbital masses. They are difficult to treat since they do not remain within anatomic boundaries and tend to penetrate into normal orbital structures. The aim was to analyze clinical courses and therapy options in patients with lymphatic malformations of the orbit.
  
  
  METHODS
  Thirteen patients with orbital lymphatic malformations confirmed by magnetic resonance imaging between 1998 and 2009 were enrolled in this study. Patients' charts were retrospectively reviewed to analyze clinical courses and treatment options.
  
  
  RESULTS
  Four patients suffered from isolated intraorbital lymphatic malformations without conjunctival involvement, in three of them the masses were completely resected, in one patient close controls were performed. Three patients had isolated intraorbital lymphatic malformations with conjunctival involvement. Surgical volume reduction of the exterior parts of the lymphatic malformation were performed without any complications and satisfying outcome in these cases. Six patients suffered from intra- and periorbital lymphatic malformations. In 3 patients a watch-and-wait strategy was initiated. In the other 3 patients a surgical therapy was performed, one patient additionally received sclerotherapy with OK-432; however, these 3 patients suffered from residual lymphatic malformations.
  
  
  CONCLUSIONS
  The presented cases underline the inconsistencies in the malformations behavior and underscore the inability to make specific recommendations regarding treatment. The treatment decision should be based on the size and location of the lymphatic malformation. The untreated patient must be watched for signs of visual detoriation, which may signal the need for therapeutic intervention.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University Hospital Giessen & Marburg, Marburg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Wiegand
authors.forename: Behfar
authors.initials: B
authors.lastname: Eivazi
authors.forename: Linda M
authors.initials: LM
authors.lastname: Bloch
authors.forename: Annette P
authors.initials: AP
authors.lastname: Zimmermann
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Sesterhenn
authors.forename: Stephan
authors.initials: S
authors.lastname: Schulze
authors.forename: Jochen A
authors.initials: JA
authors.lastname: Werner
keywords: Lymphatic malformation; OK-432; Orbit; Orbitotomy