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Orbital Schwannoma-Management and Clinical Outcomes.
Yong, Kai-Ling; Beckman, Timothy J; Cranstoun, Matthew; Sullivan, Timothy J.
Afiliación
  • Yong KL; Department of Ophthalmology, Royal Brisbane and Women's Hospital.
  • Beckman TJ; Faculty of Medicine, University of Queensland.
  • Cranstoun M; Department of Ophthalmology, Queensland Children Hospital, Brisbane, Queensland, Australia.
  • Sullivan TJ; Oculoplastic Department, Singapore National Eye Centre, Singapore.
Ophthalmic Plast Reconstr Surg ; 36(6): 590-595, 2020.
Article en En | MEDLINE | ID: mdl-32282644
PURPOSE: To evaluate the clinical features, management, and outcomes of orbital schwannomas. METHODS: Retrospective study analyzing 20 orbital schwannomas in 18 patients managed in an orbital service over 26 years. Clinical, radiological, histological, and surgical procedural data were analyzed. RESULTS: Mean age of the study population was 40.89 ± 20.84 years. The most common nerve of origin was frontal nerve (50%), and majority of patients (70%) had a superior and/or posteriorly located tumor. Five patients (27.8%) had optic neuropathy at presentation, and 3 of them showed improved vision after intervention. Surgical resection was performed for all except for 1 patient who underwent fractionated stereotactic radiotherapy. Six subjects had extension of tumor into the cavernous sinus, and 3 of them underwent combined neurosurgical intervention with stereotactic neuronavigation. Outcomes were largely favorable with majority achieving complete excision. Two out of 6 incomplete resections experienced regrowth requiring second surgical intervention. Surgical complications include decreased vision, diplopia, ptosis, and mydriasis. CONCLUSION: Orbital schwannomas are uncommon slow-growing tumors which can result in visual loss. Prognosis can be favorable even in presence of pre-operative optic neuropathy if there is early intervention. Schwannomas confined to the orbit can usually be completely excised with good outcomes. Schwannomas extending intra-cranially may undergo incomplete excision to preserve vital structures, leaving residual disease, but generally have satisfactory results. Stereotactic neuronavigation and frozen section are useful intra-operative tool to aid management and minimize complications. Fractionated radiotherapy can be considered as an alternative or adjunctive treatment for patients not amenable for surgical resections.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Seno Cavernoso / Radiocirugia / Neurilemoma Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies Límite: Adult / Humans / Middle aged Idioma: En Revista: Ophthalmic Plast Reconstr Surg Asunto de la revista: OFTALMOLOGIA Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Seno Cavernoso / Radiocirugia / Neurilemoma Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies Límite: Adult / Humans / Middle aged Idioma: En Revista: Ophthalmic Plast Reconstr Surg Asunto de la revista: OFTALMOLOGIA Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos