Abstract | BACKGROUND: Vision-threatening intraorbital dermoid cysts have traditionally been treated by complete surgical resection. Such radical surgical intervention may pose serious risks to both vision acuity and cosmesis. We describe a novel, minimally invasive approach for the treatment of orbital dermoid cysts. METHODS: This is an interventional retrospective case series. Two patients (17 and 4 years) presented with large intraorbital dermoid cysts. The first patient had a dumbbell-shaped lesion involving the temporalis fossa and superotemporal orbit. The second patient had a large, superior intraorbital lesion. Both patients presented with visual disturbance, globe displacement, and eyelid ptosis. A series of techniques were developed and implemented for percutaneous access, drainage, and catheter-based ablation (dual drug technique) of both orbital dermoid cysts. Initial access was gained with a 14-gauge angiocatheter needle system, followed by serial emulsification and drainage of the cyst contents. A 5-French catheter was coaxially placed for fluoroscopic contrast cyst definition and subsequent dual drug chemical ablation ( sodium tetradecyl sulfate and ethanol). Suction drainage was maintained for 24 hours following ablation. RESULTS: Radiological and clinical evaluation demonstrated complete resolution of the dermoid cysts with no recurrence at 12-month follow-up in the first patient and 3 months in the second patient. Cosmetic results were excellent. Patients reported no pain and there were no neurologic, oculomotor, infectious, hemorrhagic, or other complications. CONCLUSIONS: Minimally invasive percutaneous drainage and ablation appears to be a promising treatment for large orbital dermoid cysts which would otherwise require extensive surgery to excise. Collaboration of an ophthalmologist and interventional radiologist is essential for evaluation, treatment, and follow-up.
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Authors | Richard P Golden, William E Shiels 2nd, Kenneth V Cahill, Gary L Rogers |
Journal | Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
(J AAPOS)
Vol. 11
Issue 5
Pg. 438-42
(Oct 2007)
ISSN: 1091-8531 [Print] United States |
PMID | 17681813
(Publication Type: Case Reports, Journal Article)
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Topics |
- Adolescent
- Catheter Ablation
(methods)
- Child, Preschool
- Dermoid Cyst
(diagnosis, surgery)
- Drainage
(methods)
- Female
- Follow-Up Studies
- Humans
- Magnetic Resonance Imaging
- Male
- Orbital Neoplasms
(diagnosis, surgery)
- Tomography, X-Ray Computed
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