Clinician's approach for spectrum of orbital diseases: An overview.

Abstract

To study the varied clinical presentation and outcome of management of orbital diseases and to ascertain the concordance of FNAC with histopathology. This is a prospective interventional study wherein each patient's clinical presentation was noted. Outcome of management was evaluated based on symptomatic relief, regression of signs, noting any intraoperative or postsurgical complication, recurrence, and cosmetic result in terms of surgical scar. Neoplasia was commonest 33/76; (43.42%), followed by infective and inflammatory conditions 21/76; (27.63% cases), thyroid-associated orbitopathy accounting for 12/76 cases (15.78%), whereas cystic lesions and vascular malformations were 4/76 (5.26%) each. Other disorders constituted a mere 2.65%. Proptosis was the commonest mode of presentation. It was seen in seventy out of seventy-six patients (92.1%). In 86.3% of the cases, there was successful surgical outcome. Of 22 surgically managed cases, recurrence was noted in three cases (13.6%). 90% concordance was seen with histopathology in cases where FNAC was done prior to surgery for diagnosing nature of disease. Majority of orbital and adnexal conditions can be provisionally diagnosed based on imaging; however, an adjunct invasive investigation such as FNAC or biopsy may be required. In the present study, in seven cases (9.2%) FNAC was needed, whereas in two cases (2.63%) biopsy was needed. A definitive diagnosis was confirmed by histopathology in 22 surgically managed cases and by excision biopsy in two. 22/76 (28.94%) of the cases needed surgical treatment, and other cases required conservative or palliative approach.