ORBITAL TUMORS

GENERAL CONSIDERATIONS

Tumors may affect the structures within the orbit. As these tumors slowly enlarge, the eye bulges forward and eye movement may be limited. Management of these tumors usually requires a sophisticated diagnostic evaluation including orbital CT scan and occasionally MRI studies. While many of these tumors are benign, malignant orbital tumors are often aggressive and can potentially be life-threatening. Even benign orbital tumors may cause vision loss, double vision, and significant eye and orbital damage owing to their size and location. Surgery is usually required to establish the correct diagnosis and rule out malignancy.

SURGICAL TREATMENT

Ultimately, the scope of tumor removal depends on the diagnosis, natural history of the tumor, and the ability to safely remove the tumor while avoiding damage to essential orbital structures in the process. The type of incision is predicated on the size and location of the tumor and can be variously performed through a lateral incision with or without bone removal, medial incision, orbital floor incision, orbital roof incision, transconjunctival incision, or endoscopic (through a surgical scope via small incision) approach. These techniques can be utilized separately or in combination. Orbital tumor excision is performed under general anesthesia on an outpatient basis.

AFTER SURGERY

Pain is minimal after surgery and no patch is required. Patients simply use antibiotic ointment at bedtime for approximately 10 days. Sutures are removed 7 to 10 following surgery in our office

RISKS AND COMPLICATIONS

Minor bruising or swelling may be expected and will likely go away in one to two weeks. Bleeding and infection, which are potential risks with any surgery, are relatively uncommon. Depending on the diagnosis (i.e. degree of tumor aggressiveness), tumor location, and size - potential risks include vision loss, double vision, incomplete tumor excision and/or spread.

CONCLUSIONS

Orbital tumors can be a serious threat based on factors related to diagnosis, size, and location. Some can even represent a serious life-threatening process. When treated with correct surgery, they can be accurately diagnosed and removed within the scope of maximizing patient safety. It is imperative to recognize that these tumors may cause vision loss and double vision and that surgery may not be able to prevent this depending on diagnosis, location, and size of the mass.