Fronto-Temporo-Orbito-Zygomatic Approach with Orbital Reconstruction in Lesions causing Unilateral Non-pulsating Proptosis

IF 0.3 Q4 SURGERY Indian Journal of Neurosurgery Pub Date : 2022-10-07 DOI:10.1055/s-0042-1744249
M. Darwish, A. Moawad
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Abstract

Background Unilateral non-pulsating proptosis can be caused by lesions with intraorbital extensions compressing the globe including sphenoid wing en plaque meningiomas and paranasal sinuses lesions. Patients and Methods We operated on 20 patients with unilateral non-pulsating proptosis using fronto-temporo-orbito-zygomatic (FTOZ) approach with orbital reconstruction in six patients. Eighteen patients had sphenoid wing en plaque meningioma, 1 patient had paranasal sinuses fungal infection with intraorbital and intracranial extension, and 1 patient had frontal sinus dermoid with intraorbital extension. Results Proptosis was corrected in 50% of the patients, improved in 25%, and remained stationary in 25%. Vision improved in three patients, remained stationary in three, and deteriorated in one patient. Two patients had temporary oculomotor ophthalmoplegia that resolved within 3 months. Conclusion Although it is an invasive approach, FTOZ gives excellent exposure of the orbit and anterolateral skull base that allows the excision of intracranial lesions with orbital extension. If needed, the orbit could be reconstructed easily due to excellent exposure.
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额颞眶颧入路眶重建术治疗单侧非搏动性突出病变
背景:单侧非搏动性眼球突出可由眼眶内扩张压迫眼球引起,包括蝶翼斑脑膜瘤和鼻窦病变。患者与方法采用额-颞-眶-颧(FTOZ)入路对20例单侧非搏动性眼球突出患者行眶重建手术。蝶翼斑脑膜瘤18例,鼻旁窦真菌感染伴眶内及颅内延伸1例,额窦皮样部伴眶内延伸1例。结果50%的患者脊柱突出得到矫正,25%的患者脊柱突出得到改善,25%的患者脊柱突出保持不变。3名患者视力改善,3名患者视力保持稳定,1名患者视力恶化。2例患者出现暂时性动眼性眼肌麻痹,3个月内痊愈。结论虽然是一种侵入性入路,但FTOZ可以很好地暴露眼眶和前外侧颅底,从而可以切除眼眶延伸的颅内病变。如果需要,由于良好的曝光,轨道可以很容易地重建。
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CiteScore
0.40
自引率
0.00%
发文量
52
审稿时长
12 weeks
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