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目的 探讨眼球后肿瘤摘除手术设计怎样充分结合CT及B超检查情况来设计,使手术进路更方便、肿瘤易摘除,且损伤小。在没有开眶情况下肿瘤全部取出成功,并尽可能保存视力。方法 本组14例,5例经球结膜切口进入,9例经睑皮肤切口进入,无1例开眶,术中均完整取出肿瘤。结果 术后一月复查时有6眼视力同术前,7例较术前视力下降1～2行,1例术前视力0.6,术后视力0.1。术后病理诊断:海绵状血管瘤8例,眶内神经纤维瘤2例,混合瘤4例。结论 CT能显示肿瘤位置、大小、形态与邻近组织的关系,对手术进路的选择,术中可能接触到组织及肿瘤性质的估计提供有力参考。因此,CT是眶内肿瘤的首选检查方法。B超所显示的声像图为眼球和眶内容的二维切面图,对了解眶内病变更有帮助。因此,对于眶内肿瘤术前经CT及B超检查后设定一种方便的不开眶的手术进路,完整摘除肿瘤,对患者损伤小,是可行的、有效的。
Objective To investigate how to design a fully resected CT and B-ultrasound examination after enucleation of the tumor, so that the surgical approach is more convenient, the tumor is easy to be removed and the damage is small. In the absence of orbital tumor removed completely successful, and save vision as much as possible. Methods The group of 14 patients, 5 patients entered the conjunctiva incision, 9 patients through the eyelid skin incision access, no open orbital surgery were complete removal of the tumor. Results There were 6 eyes with preoperative visual acuity in January and 7 cases with preoperative visual acuity decreased by 1 ~ 2 lines. One case had preoperative visual acuity of 0.6 and postoperative visual acuity of 0.1. Postoperative pathological diagnosis: cavernous hemangioma in 8 cases, 2 cases of orbital nerve fibroma, mixed tumor in 4 cases. Conclusion CT can show the relationship between tumor location, size, morphology and adjacent tissues. It provides a powerful reference for the choice of surgical approach, the possibility of exposure to the tissue and the nature of the tumor during operation. Therefore, CT is the preferred method of examination of orbital tumors. Ultrasound images displayed by B-ultrasound for the eye and orbital contents of the two-dimensional cutaway, to understand orbital lesions more helpful. Therefore, preoperative orbital tumor by CT and B-ultrasound set a convenient non-orbital surgical approach, complete removal of the tumor, the patient is small, is feasible and effective.