Article
Deep vascular orbital lesions
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Published: | May 20, 2009 |
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Outline
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Objective: There are rare descriptions of vascular orbital malformations. We present the haemodynamics and endovascular and/or surgical treatment of deep vascular orbital lesions.
Methods: We report on our series of 58 vascular lesions of the orbit treated between 1991 and 2008.
Results: We distinguish between three types of haemodynamics. Most common are arteriovenous malformations characterized by direct low flow such as cavernous haemangiomas (n=44), treated by complete excision. Capillary haemangiomas (n=1) undergo spontaneous regression. Surgery is appropriate in well-circumscribed lesions. Direct anterograde high flow lesions like AVMs are rare (n=4), undergoing an endovascular and/ or surgical treatment. Venous flow lesions appear as distensible lesion (n=3) with rich communication or non-distensible anomalies (n=4). Deep venous lesions (n=7) should be treated if they cause severe pain, cosmetic disturbances or visual deterioration.
No flow lesions have little connection to the vascular system and include lymphangiomas (n=2). Surgery may be helpful in distinct cases with intracystic haemorrhage.
Conclusions: The haemodynamic and clinical presentation of the vascular lesion determine the recommended treatment. Generally, we favour early treatment after the onset of symptoms.