Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/81230
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Type: Journal article
Title: Endoscopic transethmoidal approach with or without medial rectus detachment for orbital apical cavernous hemangiomas
Author: Wu, W.
Selva-Nayagam, D.
Jiang, F.
Jing, W.
Tu, Y.
Chen, B.
Shi, J.
Sun, M.
Qu, J.
Citation: American Journal of Ophthalmology, 2013; 156(3):593-599
Publisher: Elsevier Science Inc
Issue Date: 2013
ISSN: 0002-9394
1879-1891
Statement of
Responsibility: 
Wencan Wu, Dinesh Selva, Fangzheng Jiang, Wentao Jing, Yunhai Tu, Ben Chen, Jieliang Shi, Michelle T. Sun, and Jia Qu
Abstract: To determine the indications for the addition of a transcaruncular approach along with detachment of the medial rectus muscle during the removal of small apical cavernous hemangiomas using an endoscopic transethmoidal approach.Retrospective, noncomparative case series.Multicenter study of 12 patients with apical orbital tumors removed using an endoscopic transethmoidal approach. The decision to detach the medial rectus muscle with the addition of a transcaruncular approach was made during surgery for tumors largely lateral to the medial rectus muscle. Tumors adjacent to the medial orbital wall were removed via an endoscopic transethmoidal approach alone.Seven tumors were removed via an endoscopic transethmoidal approach combined with medial rectus muscle detachment, whereas 5 patients underwent removal without detachment of the medial rectus. All patients had visual impairment. Complete excision of the hemangiomas was achieved in all patients and tumor size ranged from 6 × 5 mm to 20 × 12 mm. The mean postoperative follow-up time was 11.8 ± 4.3 months. At final follow-up, the best-corrected visual acuity improved in 11 patients. Three patients had transient horizontal diplopia resulting from partial paralysis of the medial rectus muscle after detachment during surgery.The endoscopic transethmoidal approach with or without medial rectus detachment is a promising approach for selected small cavernous hemangiomas located at the deep medial orbital apex. Detachment of the medial rectus muscle can be a useful technique for tumors located largely lateral to the medial rectus muscle. Further studies will be required to demonstrate the safety and efficacy of this technique.
Keywords: Oculomotor Muscles; Ethmoid Sinus; Humans; Hemangioma, Cavernous; Orbital Neoplasms; Tomography, X-Ray Computed; Endoscopy; Treatment Outcome; Ophthalmologic Surgical Procedures; Retrospective Studies; Visual Acuity; Adult; Middle Aged; Female; Male; Young Adult
Rights: © 2013 by Elsevier Inc. All rights reserved.
RMID: 0020131348
DOI: 10.1016/j.ajo.2013.05.001
Appears in Collections:Opthalmology & Visual Sciences publications

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