Sathyadeepak Ramesh1,2, Gary Duckwiler3, Robert A Goldberg4, Daniel B Rootman4,5. 1. Eye and Facial Plastic Surgery Consultants, Philadelphia, PA. 2. Division of Orbital and Ophthalmic Plastic Surgery, Department of Ophthalmology, Wills Eye Hospital, Philadelphia, PA. 3. Division of Interventional Neuroradiology, Department of Radiology, UCLA Medical Center, Los Angeles, CA. 4. Division of Orbital and Ophthalmic Plastic Surgery, Department of Ophthalmology, UCLA Stein Eye Insitute, Los Angeles, CA. 5. Division of Orbital and Ophthalmic Plastic Surgery, Department of Ophthalmology, Doheny Eye Insitute, Los Angeles, CA, U.S.A.
Abstract
PURPOSE: To review a representative case series and share a stepwise approach to the diagnosis and treatment of periorbital venolymphatic malformations. METHODS: A case series of 9 patients with representative periorbital venolymphatic malformations. All patients managed at the University of California, Los Angeles Orbital Center for a vascular malformation over the last 5 years were reviewed. Cases representative of the varied pathologic findings and techniques were selected. The clinical, radiologic, and intraoperative findings are presented and a survey of techniques composed. RESULTS: Venolymphatic malformations can have protean manifestations. Characteristics vital to the understanding and management of these lesions are the classification and vascular composition of the lesion, internal flow and drainage patterns, anatomic localization and association with distant components. Options for treatment include sclerotherapy, biologic therapy, embolization, surgical excision, or some combination thereof. CONCLUSIONS: A comprehensive understanding of each patient's unique lesion is critical to a rational treatment approach. Teamwork and creativity are key to effectively managing these lesions.
PURPOSE: To review a representative case series and share a stepwise approach to the diagnosis and treatment of periorbital venolymphatic malformations. METHODS: A case series of 9 patients with representative periorbital venolymphatic malformations. All patients managed at the University of California, Los Angeles Orbital Center for a vascular malformation over the last 5 years were reviewed. Cases representative of the varied pathologic findings and techniques were selected. The clinical, radiologic, and intraoperative findings are presented and a survey of techniques composed. RESULTS: Venolymphatic malformations can have protean manifestations. Characteristics vital to the understanding and management of these lesions are the classification and vascular composition of the lesion, internal flow and drainage patterns, anatomic localization and association with distant components. Options for treatment include sclerotherapy, biologic therapy, embolization, surgical excision, or some combination thereof. CONCLUSIONS: A comprehensive understanding of each patient's unique lesion is critical to a rational treatment approach. Teamwork and creativity are key to effectively managing these lesions.