Recently, doctors at Viet Tiep Friendship Hospital successfully performed a mass surgery eye socket tumor left side for PTB patient, 69 years old, (Tien Lang, Hai Phong). The patient came to the doctor with symptoms of a bulging left eye accompanied by blurred vision, limited eye movement, and pain in the left eye area for many months. Previously, the patient had been examined and treated at many places, but her condition did not improve, her eyes became more bulging and her vision gradually became blurred.
The patient was directly examined by Dr. Nguyen Quoc Son – Deputy Head of the Ophthalmology Department and received an initial diagnosis: The left eye bulged a lot compared to the right eye, pain, VI nerve paralysis, unable to move the eye out. , visual acuity in the left eye is still present, positive in light and dark. After performing the necessary clinical tests, a cranial magnetic resonance imaging scan showed that the patient had a tumor in the left eye socket measuring 15x39mm. The mass pushes the lateral rectus muscle and compresses the optic nerve, pushing the eyeball outward.
Tumor location on brain magnetic resonance imaging results.
Realize this is a special case: eye socket is an anatomically delicate area containing the eyeball with many important neurovascular structures; The tumor is located in the eye socket and presses on the optic nerve. Therefore, Dr. Nguyen Quoc Son, Deputy Head of the Ophthalmology Department, consulted with Dr. Dang Viet Son, Head of the Department of Cranio-Spine Surgery to agree on a surgical plan.
The patient underwent microsurgery through the temporal skull (extracranial incision into the eye socket through the eyebrow), accessing the ceiling and outer wall of the eye socket to reach the tumor, dissecting and removing the tumor invading 3/4 of the external rectus muscle. , suturing the remaining rectus muscle. Transtemporal craniofacial microsurgery has the advantage of accessing the entire tumor, requiring no or very little bone cutting, cosmetic surgery scars, helping to completely remove the tumor, avoiding damage to eyelid ptosis and closed eyes. not tight after surgery.
The surgery was successful. After the intervention, the patient was treated for recovery at the Department of Cranio-Spine Surgery. Currently, the patient’s condition is stable, the left eye can see clearer on the 3rd day after surgery, the bulging eyes are gone and there is no longer any eye pain; The left eye shows signs of 10 degrees of external strabismus. Once stable for 1 week, the patient will undergo surgery to retract the external rectus muscle to straighten the eyeball axis and improve eye movement.
According to Doctor Nguyen Quoc Son, the eye socket is an area with a small volume, complex anatomical structure, very diverse pathological lesions and is difficult to diagnose and treat due to diverse, complex and unpredictable symptoms. specific so it is often difficult to distinguish from other diseases in the eye and neighboring organs.
The phenomenon of strange tumors appearing in the body eye socket called an orbital tumor. Orbital tumor is a rare disease with nonspecific clinical symptoms. However, this is a disease that can occur in everyone.
Although most cases are benign, a significant proportion are malignant. When not well controlled and treated, these tumors easily cause damage to nerves, blood vessels around the eyes and eye muscles. Ultimately, the patient gradually loses vision, even goes blind, and significantly reduces life expectancy. Therefore, early detection, diagnosis and treatment of orbital tumors is very important.
“In terms of diagnosis, the development of magnetic resonance imaging/computed tomography has helped accurately diagnose tumor location, guide diagnosis and treatment strategies. Regarding treatment, advances in neurosurgery, surgery on surgical biomicroscopy systems, and microsurgical instruments have helped to approach all types of retrobulbar tumors accurately and safely. Surgery is the first choice to diagnose pathology and resolve damage” – Dr. Nguyen Quoc Son added.
For patients with orbital tumors, early diagnostic examination along with MRI 3.0 magnetic resonance imaging results, combining specialties and choosing appropriate surgical methods is extremely important. At the same time, microsurgery through the temporal skull requires the doctor to be skilled, careful and skillful. Therefore, people need to see a doctor early when there are signs of abnormalities in the eyes.”