Diagnosis and Surgical Treatment of Orbital Tumors of Various Localizations and Histostructures.

Abstract

The article reviews and analyzes the results of treatment of 32 patients with orbital tumors operated in the clinic, neurosurgery until the period from 2015 till September 2019. Goals and objectives: coverage of clinical signs and symptoms, histology, diagnostic methods and treatment of patients operated on with orbital tumors during the period 2015-2019. Determination of optimal surgical approach to the tumors with different localization for performing the radical organ-preserving surgery, with maximal saving of visual functions, minimization of oculomotor disorders, patient disability. Materials and Methods: we analyzed the clinical cases of 32 patients undergoing treatment in DOKTMO with orbital tumors for the period from 2015 till September 2019. Patients were operated on with various approaches - transcutaneous, subconjunctive (without orbitotomy), fronto-orbito-zygomatic, pterional, subfrontal (neurosurgical approaches), transmaxillary, transethmoidal (ENT approaches). The choice of surgical approaches were individual. In 2 cases we become a backset of tumor growth: one patient with aggressive adenocarcinoma, after 18 months, leading to orbital exentration and the child, 9 years old with rhabdomyosarcoma after non-radical removal of tumors of subconjunctival approach. In all other cases, relapses were not detected, operation were organ-preserving oriented. Conclusions: the results of treatment of patients with tumors directly depend on the choice of radicality tumor removal, which is associated with the choice of surgical approach, chemical, radiation treatment in postoperative period depending on the histological response. From our point of view, the most universal method for tumor removal with various localizations and sizes is fronto-orbito-zygomatic approach which provides the performance of radical organ-preserving operation with maximal vision saving, minimizing oculomotor disorders, disability of the patient, despite its technical complexity for ophthalmologist surgeons. In this regard, surgery of orbital tumors is subject to the competence of doctors of related specialties.