Navigation-Assisted Intraorbital Osteoma Excision - Case Report

透過導航輔助進行眼眶內之骨腫瘤切除－病例報告

柯安達(An-Ta Ko) ； 湯月碧(Yueh-Bih Tang Chen) ； 簡雄飛(Hsiung-Fei Chien) ； 謝孟祥(Thomas Mon-Hsian Hsieh)

《臺灣整形外科醫學會雜誌》 25卷3期 (2016/09) Pp. 217-226

摘要

背景：骨瘤(osteoma)是臨床上副鼻竇最常見生長緩慢的良性骨腫瘤，通常侷限在額竇內並且很少產生臨床症狀。當有臨床症狀產生並對病人生活產生影響時，就會建議病人接受手術。其中發生在額竇(frontal sinus)的骨瘤延伸進眼眶內是相當罕見。而且如果骨瘤又同時合併有顱內延伸(intra-cranialextension)的情形會讓手術技術更困難。目的及目標：描述使用導航系統在臨床上對眼窩內腫瘤切除的好處材料及方法：我們報告一個罕見的眼眶內骨瘤合併有顱內延伸的案例。利用導航系統(navigation system)的幫助，我們嘗試把骨瘤切除的更完全，減少對其他組織之傷害，讓腫瘤切除邊緣可以更精準並且避免掉不需要之破壞，重建手術也因此不會太複雜，降低重建手術的困難度，眼眶頂骨頭缺損的重建方式也有描述在文章中。結果：追蹤手術後的情形，病人對於術後的外觀及結果也感到相當滿意。結論：導航系統是個可依賴的輔助工具，能夠幫助精準的定位腫瘤，減少不必要之骨頭切除，讓重建手術較為容易，且減少合併症的發生。

並列摘要

Background: Intraorbital osteoma is rare. Less than 10 percent of osteoma cause symptom. Surgical management is indicated for symptomatic osteoma. However, intracranial extension make the surgery even more difficult. Aim and objectives: This study aimed to describe the benefit of navigation system-guided for intraorbital osteoma excision Material and Methods: We present one case of intraorbital osteoma with frontal and ethmoid sinus extension. Result: With the aid of navigation system, the resection margin could be designed more accurate to avoid the supra-orbital foramen. The osteoma was excised completely and avoid to injure the surrounding vital structure. Conclusion: Navigation system is a reliable tool for localizing the target tumor and reduce the range of skull bone to be cut. We recommend a concentric shaped window for tumor excision under navigational assistance. The reconstruction can be relatively easier and the incidence of complication and morbidity may be reduced.

並列關鍵字

osteoma ； navigation system