Cryo-extraction of Orbital Cavernous Hemangioma

¹Holland D., ²Eggers S., ²Maune S.,
¹Christian-Albrechts-Universität Kiel, Klinik für Ophthalmologie (Kiel)
²Christian-Albrechts-Universität Kiel, Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirugie (Kiel)

Purpose: Cavernous hemangioma is the most common vascular tumor of the orbit. It is characterized by a slow progression and often reaches a considerable size until clinical manifestation. The localisation is most often within the muscle cone. This may lead to a difficulties concerning tumor exstirpation and iatrogenic trauma of important surrounding tissues. Complete excision is important to avoid a relapse. We demonstrate three cases of successful therapy of orbital hemangioma by cryoextraction.
Method: The surgical approach is determined by size and localisation of the tumor. A circumscribed area of the hemangioma is prepared to place the cryoprobe on the surface for freezing the tumor. By circling movements of the cryoprobe the frozen tumor is carefully separated from the surrounding tissues. To achieve a complete freezing the cryoprobe is set on different parts of the tumor during this maneuver. Sharp preparation ideally is not needed and therefore risk of iatrogenic trauma is slight.
Results: In all three cases demonstrated a total removal of the hemangioma was possible without complications by iatrogenic trauma.
Conclusion: Cryoextraction of cavernous orbital hemangiomas is a simple operative technique that allows a total removal. The technique is characterized by a less traumatic preparation of the tumor and spares the relevant surrounding orbital tissues.

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