The nature of orbital tumors cannot be predicted. Mostly, all orbital tumors are benign in nature but some of them can also be malignant. So, be it an adult or a child, a man or a woman anyone can be affected by orbital tumors. One of the most common types of orbital tumors which can affect adults is known as orbital cavernous hemangiomas. Orbital cavernous hemangiomas are vascular orbital lesions which mostly are well- circumscribed. Orbital cavernous hemangiomas are benign and non-infiltrative but they can intrude other orbital structures, therefore they can be considered to be anatomically malignant. They progress mostly unilaterally and slowly in the body. As they increase in size, the intraorbital volume is increased. They restrict the motility and generally the consequent proptosis is axial. Bilateral cases in which the tumor affects both the eyes are very rare. If the tumor is situated in the conal apex, the optic nerve can be compressed without any significant external symptom.
Orbital cavernous hemangiomas can affect anyone. Orbital cavernous hemangioma affects more females as compared to males. Also, cavernous hemangiomas generally occur in middle aged people. In most cases, the orbital cavernous hemangioma is situated laterally to the optic nerve. Orbital cavernous hemangiomas are considered to be a type of congenital abnormality. However, there is no evidence to show that orbital cavernous hemangiomas can be hereditary. Orbital cavernous hemangiomas manifest very slowly in the body. They are detected when there is a change in the visual acuity, pupillary dysfunction or change in the appearance in the patient’s eye. Since orbital cavernous hemangiomas are a type of congenital abnormality, normally there is not anything that can be done to prevent orbital cavernous hemangiomas. Because orbital cavernous hemangiomas develop slowly in the body, they do not show up with sudden symptoms. Generally, orbital cavernous hemangioma may cause the patient’s eye to bulge without any pain and the patient may also feel some inexplicable fullness in the eyelids. Generally, orbital cavernous hemangiomas are found in the ocular muscle cone.
Many cases have been reported from all over India, in which orbital cavernous hemangiomas were discovered accidently while the patient was being tested for some other symptoms. Orbital cavernous hemangiomas may sporadically present some symptoms like severe headache, double vision, lack of visual clarity which is temporary. Also, the orbital cavernous hemangiomas can cause damage to the optic nerves. In very few cases they cross over through superior orbital fissures. In most cases, no inflammation is caused by orbital cavernous hemangiomas.
Diagnosis of orbital cavernous hemangiomas:-
Before any treatment is begun for orbital cavernous hemangiomas, for the diagnosis the rate of the growth of orbital cavernous hemangiomas is observed. Since orbital cavernous hemangiomas grow very slowly, it can be long before any symptoms actually show up. Therefore, the rate of growth of orbital cavernous hemangiomas is observed. For diagnosing the extent of orbital cavernous hemangiomas, various vision tests are performed. The patient’s vision is assessed for double vision, color assessment and vascular damage. In an ultrasound, the tumor shows up as a reflective tumor which is an oval or roundish mass.
Treatment of orbital cavernous hemangiomas in India:-
The top approach that is taken for the treatment of orbital cavernous hemangiomas in India is not an aggressive one. The best treatment approach and the decision about surgery completely depend upon how the symptoms are manifesting in the ocular area by orbital cavernous hemangiomas. If the orbital cavernous hemangioma is not very big and the symptoms are not very visible, the treatment involves making the patients take various tests like the color vision, color acuity, CT scan and MRI. However, treatment in the cases where the patient has a bulging eye or episodes of double vision surgery is the best treatment approach. Surgery is done for the treatment of orbital cavernous hemangiomas in few cases. The approach which is taken for surgical intervention will depend on the intra-orbital location of the tumor and can be Transconjunctival, lateral orbitotomy or Frontotemporal approach. If the tumor has extended transcranially, then a transcranial rout may be taken for excision. An anterior approach is utilized for anteriorly located hemangioma or hemangiomas which are basal to the optic nerve. Very few intraorbital hemangiomas are surgically managed by endoscopic transnasal resection technique because treatment of lesions extending beyond paranasal sinuses has its limitations with endoscopic surgery.
Since these lesions are generally encapsulated and well- lineated, their surgical removal is not extremely complicated. They do not have and muscular tissue or an elastic membrane.
Orbital hemangiomas may cause distortion of the orbit or the eyelids. In India, the excision surgery is mostly done by an oculoplastic surgery of the orbit. In Mumbai, orbital reconstructive surgery is performed by one of the top oculoplastic surgeons of India who is Dr. Debraj Shome. For those who are unaware about oculoplastic surgery, it is a specialized branch of surgery which involves plastic and reconstructive surgery of the ocular structure. Dr. Shome is a super- specialist oculoplastic and the top facial plastic surgeon who is based in Mumbai. In India, the incidences of orbital hemangiomas are not very uncommon. Dr. Shome regularly performs surgery for orbital cavernous hemangiomas in Mumbai. But, as per Dr. Shome, not all cases need treatment by surgery. In India, it is very important to visit the best surgeon for the treatment and surgery, if required. Dr. Shome says that in Mumbai in past few years, many people were made to undergo surgery for hemangiomas which was completely not required. In Mumbai, he ensures that none of his patients are made to undergo surgery without the need to do so. In many cases he says, a reconstructive surgery may also be needed. Dr. Shome is an expert and has performed best reconstructive surgery on thousands of patients in Mumbai. He has changed the lives of many people in Mumbai by performing best treatment for restoration of function and aesthetics of the ocular area. Being the top facial plastic an oculoplastic surgeon in Mumbai, he understands the aesthetics and function of face like no other surgeon in India. It is not surprising that he has been honored several times for being the’ Best Plastic Surgeon in India’. Oculoplastic surgery is a rare and specialized branch of ophthalmology and Dr. Debraj Shome is the top qualified oculoplastic surgeon in Mumbai. Dr. Shome performs reconstructive surgery of all types at his clinics in Mumbai, India.
Dr. Shome’s expertise in oculoplastic surgery also includes treatment surgery for orbital trauma, lacrimal trauma, eyelid disorders and surgery for socket repair also. Dr. Shome has performed ptosis surgery on many young children who suffer from congenital ptosis. Surgery is not the mandatory treatment requirement for orbital tumors and in some cases surgery may only be needed as the last alternative. Your surgeon should be able to tell you about your surgery requirements for orbital tumors. In some cases of orbital tumors, other therapies like chemotherapy and radiotherapy may work better than surgery. It all depends upon the type of orbital tumor is detected.