Hudym M. Tumors of cranioorbital region and orbit. Clinic, diagnosis and surgical treatment

The thesis proposes a scientifical approach to solving the problem of improving the results of surgical treatment of cranioorbital and orbital tumors. Extended scientific data about the nature of clinical manifestations, neuroimaging and tactic of surgical treatment and postoperative complications. The results of complex examination and surgical treatment of 102 patients with cranioorbital and orbital tumors, which were treated at the Kiev City Clinical Emergency Hospital in 2000–2016, were analyzed. The age of the patients ranged from 18 to 77 years, 76 (74,6%) female, 26 (25,4%) male. Surgical resection was performed for all patients, and 4 patients had repeat procedures because of early postoperative complications. In 71 (69,6%) patients complete removal was performed, in 31 (31,4%) patients subtotal. 85 (83,2%) patients had benign and 17 (16,8%) had malignant tumors. Among benign tumors there were 35 (34,4%) cranio orbital meningiomas, 19 (18,7%) cavernous hemangiomas, 11 (10,8%) optic nerve gliomas, 8 (7,8%), pleomorphic adenomas of the lacrimal gland, 8 (7,8%) optic nerve sheath meningiomas, 4 (3,8%) schwannomas, 1 (0,9%) neurofibroma. Malignant neoplasms include: 8 (7,8%) metastases, 4 (3,8%) adenocarcinoma of the lacrimal gland, 3 (2,9%) malignant lymphomas of the orbit, 1 (0,9%) hemangiopercytoma. 18 (17,6%) patients had early postoperative complications. The risk of complications depend on volume of removal, and did not depend on malignancy and year of surgery. Excellent result — complete regression of ophthalmic symptoms, subjective and objective satisfactory cosmetic result was registered in 45 (44,1%) patients. Good result in 35 (34.3%) patients who did not show full regression of the symptoms, as well as no signs of good and unsatisfactory result. Satisfactory result in 10 (9,8%) patients who did not improve after surgery. Unsatisfactory result in 12 (11,8%) patients who had worsening (onset or increase in visual or focal neurological deficit) after surgical treatment.