Treatment and long-term outcome of patient with orbital cavernoma

Purpoe To evaluate the long-term prognoi of viual function in patient with orbital cavernoma after conervative and urgical treatment. Deign Interventional cae erie. Method The author decribe the outcome of 20 patient with cavernou hemangioma of the orbit treated in their department between 1988 and 2003. Thi propective tudy included five cae followed by clinical and radiologic obervation and 15 cae of ymptomatic tumor that were completely removed by mean of a frontotemporal or by mean of a tranconjunctival approach. The clinical characteritic of orbital cavernoma were analyzed together with their appropriate treatment. Furthermore, the author preent the unuual cae of a patient uffering from progreive viual deterioration from a cerebral cavernoma compreing the optic nerve. Reult The follow-up period wa between 3 and 10 year. All orbital cavernoma in the group of conervatively managed patient remained table. The tranconjunctival exciion of a medially located leion wa uncomplicated. The frontotemporal approach wa choen for large tumor ituated in the proximity of the orbital apex and wa aociated with a higher number of complication. A good overall outcome of viual function and patient atifaction wa achieved in 11 of 14 cae operated on by craniotomy. Concluion The combination of clinical ign and magnetic reonance imaging (MRI) i highly enitive and pecific for the diagnoi of orbital cavernoma. In the preence of viual deterioration clearly attributable to the tumor we recommend immediate urgery, while leion producing olely exophthalmo can afely be followed by obervation. The trancranial approach offer excellent expoure and a rewarding cometic reult and may be conidered for large leion uperior and medial to the optic nerve, epecially if they involve the orbital apex.