关键词: 内镜手术, 眼眶海绵状血管瘤

Abstract: Objective To analyze the effect of endoscopic transnasal surgery for orbital cavernous hemangioma(OCH). Design Retrospective case series. Participants 47 patients with OCH who underwent endoscopic transnasal surgery in the Department of Rhinology of Beijing Tongren Hospital from September 2008 to December 2024. Methods General information, clinical characteristics, examination results, surgical approaches and outcomes of the patients were collected. The clinical characteristics and surgical efficacy of the patients were analyzed. Main Outcome Measures Visual acuity, visual field, surgical modality, operation duration and intraoperative and postoperative complications. Results Among the 47 cases of OCH, 12 were extraconal, 34 were intraconal, and 1 was intranervous. Before surgery, 34 patients had decreased vision, 41 had visual field defects, 12 had exophthalmos, 4 had diplopia, and 9 had headache or eye pain. Total tumor resection was achieved in 35 cases, and 22 cases underwent reconstruction of the orbital wall with the perpendicular plate of the ethmoid bone. Six cases underwent orbital and optic nerve decompression, 1 case underwent partial tumor resection, orbital decompression, and optic nerve decompression, 1 case underwent orbital decompression and optic nerve decompression with intratumoral injection of bleomycin, 2 cases underwent partial tumor resection and orbital decompression, and 2 cases underwent only orbital decompression. The average follow-up period after surgery was （52.9±28.3） months. The preoperative mean best-corrected visual acuity (BCVA) in 34 patients presenting with visual impairment was 0.35±0.36, which improved to 0.56±0.38 postoperatively (P=0.001). Among 41 patients with visual field defects before surger, 33 showed a significant reduction in the extent of the defect after surgery. The mean deviation (MD) improved from (-21.23±8.29) dB preoperatively to (-12.78±9.75) dB postoperatively (P<0.001). All 12 patients with exophthalmos demonstrated marked improvement, with exophthalmometry measurements decreasing from (16.50±1.78) mm preoperatively to (14.08±1.78) mm postoperatively (P=0.002). Conclusion Endoscopic surgery via the nasal approach for OCH is a safe and effective method. The use of the perpendicular plate of the ethomoid bone for postoperative orbital wall reconstruction is an advantage of endosopic transnasal surgery.  (Ophthalmol CHN, 2025, 34: 123-129)

Key words: endoscopic surgery, orbital scavernous hemangioma