Surgical management of bony orbit tumors

Abstract

Background

A variety of primary tumors affect the bony orbit. They include, sphenoid ridge meningioma, fibrous dysplasia, ossifying fibroma, osteoma and aneurismal bone cyst. Controversies in the treatment strategies still exist. This study is retrospective study that included 20 patients operated upon in the last three years—at neurosurgery department in Minia University Hospital—with tumors related to the bony orbit. We studied the data, to see what was done, what should have been done. CT and MRI were used for all patients preoperatively and for postoperative follow-up.

Results

Fourteen patients had sphenoid ridge meningiomas, two patients had osteomas, two patients had fibrous dysplasia, one had ossifying fibromas and one aneurysmal bone cyst. Proptosis improved in all cases. But one patient had deterioration of vision. There were no postoperative cases of enophthalmos or pulsating exophthalmos.

Conclusions

Early surgical intervention is mandatory before the tumor becomes less amenable. Both CT and MRI should be done preoperatively. Opening the bony superior orbital fissure is a mandatory step in all cases, whereas the optic canal should be drilled out open only if the optic nerve is compromised within the canal. Thorough knowledge of the skull base operative techniques is a must.