[Surgical treatment of orbitocranial and orbital cavernous venous malformations (ophthalmological aspects)].

Abstract

Background: Orbital cavernous venous malformation is a vascular malformation with slow blood flow velocity and common orbital lesion in adults.

Objective: To analyze surgical treatment of orbitocranial and orbital cavernous venous malformations and factors influencing the outcomes.

Material and methods: The study included 54 patients with apical orbital cavernous venous malformation extending into the cranial cavity (group I) and 31 patients with cavernous venous malformation of anterior and/or middle third of the orbit (group II) between 2004 and 2024.

Results: The following approaches were used for resection of malformations: osteoplastic lateral orbitotomy, supraorbital, orbitozygomatic, endoscopic transnasal, transconjunctival approach. In early postoperative period, 15 patients in the 1^st group had deterioration of visual function. Of these, 8 ones developed blindness due to occlusion of central retinal artery. Most often, deterioration of visual functions was associated with extension of malformation into the optic canal, moderate-to-severe visual impairment and late preoperative stage of visual impairment (p<0.05). There was no deterioration of visual functions in the 2^nd group. Deterioration of oculomotor function was noted in 70% and 24% of cases, respectively. Exophthalmos partially or completely regressed in both groups.

Conclusion: Spread of cavernous venous malformation into the optic canal, preoperative state of visual functions and stage of visual impairment influence visual functions after surgery. Oculomotor function in delayed postoperative period is restored more often than visual functions.