Tersiyer Bir Merkezde Pediatrik Obital Dermoid Kistlerin Analizi

Özet

Amaç: Orbital dermoid kisti olan pediatrik hastaların demografik, klinik, radyolojik ve cerrahi sonuçlarını değerlendirmek. Gereç ve Yöntemler: Ocak 2008 ve Mart 2019 tarihleri arasında kliniğimizde orbital dermoid kist nedeniyle tetkik ve tedavisi yapılan pediatrik hastalar retrospektif olarak incelendi. Tüm hastalara göz hareketleri, ön segment, fundus muayenesini içeren rutin oftalmolojik inceleme sonrası hastaların klinik bulgularına göre orbital ultrasonografi, bilgisayarlı tomografi ya da manyetik rezonans görüntüleme yöntemlerinden gerekli olanlar uygulandı. Hastalara süperior kapak kıvrımı insizyonu ile kist eksizyonu yapıldı. Tüm hastaların histopatolojik incelemesi dermoid kist ile uyumluydu. Bulgular: Çalışmaya dahil edilen 16 hastanın ortalama yaşı 8.4±5.6 yıldı. Dermoid kistlerin 10’u (%62.5) zigomatikofrontal sütürde, 5’i (%31.3) frontonazal sütürde ve 1’i (%6.2) ise maksilloetmoidal sütürde yer almaktaydı. Onbeş (%93.8) hastada üst kapakta kitle, 4’ünde ptozis (%25) ve 1’inde (%6.2) proptozis mevcuttu. Hastaların 4’ünde (%25) birden fazla semptom bulunmaktaydı. Zigomatikofrontal sütürde dermoid kisti olan hastaların 9’unda (%90) üst kapakta kitle ve 3’ünde (%30) ptozis vardı. Frontonazal sütürde dermoid kisti olan hastaların 5’inde (%100) üst kapakta kitle ve 1’inde (%20) ptozis mevcuttu. Maksilloetmoidal sütürde dermoid kisti olan hastaların 1’inde (%100) üst kapakta kitle ve 1’inde (%100) proptozis vardı. Ortalama 11.8±3.3 ay takip edilen hastaların hiçbirinde operasyon sonrası komplikasyon ve rekürrens gelişmedi. Sonuçlar: Dermoid kistler orbital kitle nedeniyle başvuran pediatrik hastalarda ayırıcı tanıda yer almalıdır. Pediatrik orbital dermoid kistlerin tedavisinde süperior kapak kıvrımı insizyonu ile yapılan total eksizyon basit, güvenilir ve etkin bir yöntemdir

Abstract

Objective: To evaluate the demographic, clinical, radiologic and surgical outcomes of pediatric patients with orbital dermoid cyst. Materials and Methods: Pediatric patients with orbital dermoid cyst who were diagnosed and treated in our department between January 2008 and March 2019 were retrospectively investigated. After routine ophthalmologic inspection including eye movements, anterior segment and fundus examination, necessary imaging methods among orbital ultrasonography, computed tomography or magnetic resonance were applied according to clinical signs of patients. Cyst excision with superior eyelid crease incision was performed to all patients. All histopathologic results were in accordance with dermoid cyst. Results: Mean age of 16 patients in the study was 8.4±5.6 years. Ten (62.5%) of dermoid cysts were localized at zygomaticofrontal suture, 5 (31.3%) were localized at frontonasal suture and 1 (6.2%) was localized at maxilloethmoidal suture. Fifteen (93.8%) patients had upper eyelid mass, 4 (25%) patients had ptosis and 1 (6.2%) had proptosis. Four (25%) patients had more than one symptom. Among patients whose dermoid cysts were at zygomaticofrontal suture, 9 (90%) had upper eyelid mass and 3 (30%) had ptosis. Among patients whose dermoid cysts were at frontonasal suture, 5 (100%) had upper eyelid mass and 1 (20%) had ptosis. Among patients whose dermoid cysts were at maxilloethmoidal suture, 1 (100%) had upper eyelid mass and 1 (100%) had proptosis. None of the patients developed complication or recurrence at 11.8±3.3monthsfollow-up. Conclusion: Dermoid cysts should be included in the differential diagnosis of pediatric patients with orbital mass. Total excision with superior eyelid crease incision is a simple, reliable and effective method in the treatment of pediatric orbital dermoid cysts.