Orbital Schwannoma-Management and Clinical Outcomes.
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.
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