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2017 ; 12
(1
): 110-112
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Deep Orbital Dermoid Cyst Bulging into the Superior Orbital Fissure: Clinical
Presentation and Management
#MMPMID28299014
Kumar R
; Vyas K
; Jaiswal G
; Bhargava A
; Kundu J
J Ophthalmic Vis Res
2017[Jan]; 12
(1
): 110-112
PMID28299014
show ga
PURPOSE: To present a case of deep orbital dermoid cyst with emphasis on clinical
presentation, imaging spectrum, differential diagnosis and management. CASE
REPORT: A 28-year-old female was referred to our hospital with chief complaint of
drooping of right eyelid and progressive headache. Ocular motility, visual acuity
and fundus examination were normal. computed tomography (CT) and magnetic
resonance imaging (MRI) revealed a well-defined, intraosseous deep orbital
dermoid cyst (5.9 mm × 12.5 mm) located near the apex of right orbit, extending
from greater wing of sphenoid into the superior orbital fissure. Due to
occulomotor nerve (superior and inferior divisions) compression which passes
through the superior orbital fissure, ipsilateral headache and ptosis occurred.
Complete surgical excision of cyst was performed using noninvasive extracranial
lateral orbitotomy approach. After removal of the cyst, curette and cutting drill
were used to thoroughly remove any residual cystic content. Histopathological
analysis confirmed the diagnosis. The healing was uneventful postoperatively.
CONCLUSION: CT and MRI are easy, reliable, safe and effective imaging methods for
establishing the diagnosis of orbital dermoid cyst. Size, location and
manifestations are the most important determinants of the disease management.
Complete surgical excision without rupture of the cyst is the treatment of
choice.