A Modified Methylene Blue Staining Technique Assists in the Removal of Complex Orbital Dermoid Cysts

Abstract

Objective: To analyze a modified methylene blue staining technique applied during the surgical removal of complex orbital dermoid cysts, and to evaluate clinical outcomes of the novel procedure. Methods: We previously reported on the modified methylene blue staining technique used during surgical removal of complex orbital dermoid cysts, and retrospectively reviewed medical records of patients who had undergone the modified staining procedure from June 2014 to December 2017 in Eye & ENT Hospital of Fudan University. Results: Eight patients (8 eyes) were recruited, including seven primary cases and one recurrent case identified at the first visit. All lesions were in the superotemporal region of the orbit, with one lesion that formed a skin fistula and one lesion that extended into the temporal fossa. Clinical manifestations included diplopia (2 cases), global deviation (5 cases) and proptosis (6 cases). During surgery, modified methylene blue staining facilitated visualization and complete resection of the cysts. Follow-up duration was 2.9 years on average. CT scans showed no recurrence, and no patients complained of diplopia or global deviation. Based on histopathologic study, two cases were epidermoid cysts and six cases were dermoid cysts. Conclusions: A modified methylene blue staining technique, which facilitates visualization and complete removal of cyst walls, will play an important role in the surgical treatment of complex orbital dermoid cysts. Key words: orbit; dermoid cyst; methylene blue