Surgical treatment of orbital apex tumors by refined transcranial orbitotomy through superolateral approaches

Objective To investigate the improvement of the lateral wall of transcranial supraorbital approach treating orbital apex tumor surgical methods,indications and results. Methods Clinical data of 50 cases with orbital apex tumor hospitalized from January 2011 to December 2012 receiving tran cranial orbital surgery were retrospectively analyzed. Results Orbital-period surgery in 20 patients,orbital-the amount and orbital-zeugmatic and zeugmatic-wing combined approach surgery 30 patients. Tumor resection in 35 patients,the proportion of 70. 0%; tumor subtotal resection in 8 patients,the proportion of 16. 0%; most or partial resection in 6 patients,the proportion of 12. 0%; biopsy in one case,the ratio of 2. 0%. Orbital apex tumor types mainly meningioma cases,Neutrogena tumors,vascular / lymphatic tumors,lachrymal gland tumors,the ratio was 42. 0%,32. 0%,20. 0 %,6. 0 %. Target this group at discharge its visual function improved significantly compared to treatment or no increased 20 cases,five cases of simple posies, eye slight limitation of activity seven cases( 4 cases with posies,diplopic 3 cases),severe action five cases of optic nerve damage( including one case of schwannoma,2 cases of metastatic tumors,two cases of meningioma),decreased vision or blindness in three cases( two cases with optic nerve tumor itself,one case of crania-orbital nerve sheath tumors). After 6 months to 1 year of follow-up observation,all patients were followed up 100. 0%. Simple posies patients fully recovered,mild eye symptoms completely disappeared activity limitation,symptoms severe coulometer nerve injury significantly reduced visual acuity decreased vision returned to normal. This group of patients without recurrence and death. Conclusion Tran cranial supraorbital approach treating lateral wall orbital apex tumor is feasible to operate due to the appropriate angle,the protection of nerve function and reduction of complications and improvement of the overall effectiveness of clinical treatment.