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Indocyanine green assisted removal of orbital lacrimal duct cysts in children.

Keren S, Dotan G, Leibovitch L, Selva D, Leibovitch I - J Ophthalmol (2015)

Bottom Line: Mean follow-up period was 9.3 months.Conclusion.Intraoperative injection of ICG into orbital cysts in children can aid surgeons in identifying cyst borders following inadvertent rupture, allowing complete removal.

View Article: PubMed Central - PubMed

Affiliation: Oculoplastic and Orbital Institute and Department of Ophthalmology, Tel Aviv Medical Center, 64239 Tel Aviv, Israel ; The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

ABSTRACT
Aim. To report on the use of indocyanine green (ICG) during surgical removal of pediatric orbital lacrimal duct cysts. Method. We conducted a retrospective review of our cases of surgical excision of orbital lacrimal duct cysts using intraoperative injection of indocyanine green (ICG), which was used following inadvertent cyst rupture and volume loss. The dye allowed complete cyst visualization and complete excision despite volume loss or cyst rupture. Results. The study included 6 children (3 boys, mean age of 4.2 ± 0.84 years, range 3-5 years). Mean follow-up period was 9.3 months. All cysts were located in the inferonasal quadrant of the orbit (4 in the right side). In all cases, ICG was injected into the cyst at the time of surgery following unintentional cyst rupture. After the dye injection, it was easy to identify the borders of the cyst, permitting complete cyst removal, without any intra- or postoperative complications. Pathological examination revealed that all cysts were of lacrimal duct origin. Conclusion. Intraoperative injection of ICG into orbital cysts in children can aid surgeons in identifying cyst borders following inadvertent rupture, allowing complete removal.

No MeSH data available.


Related in: MedlinePlus

(a) Coronal CT scan showing a 2 cm homogenous inferomedial cystic mass in the right orbit. (b) Cyst exposure through a skin incision. (c) Intralesional injection of ICG. (d) Capsule demonstration and further exposure. (e) The completely excised cyst.
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fig1: (a) Coronal CT scan showing a 2 cm homogenous inferomedial cystic mass in the right orbit. (b) Cyst exposure through a skin incision. (c) Intralesional injection of ICG. (d) Capsule demonstration and further exposure. (e) The completely excised cyst.

Mentions: One of the patients had a right inferomedial cystic lesion noted soon after birth. The patient was followed up regularly and when the lesion was growing considerably, an orbital CT was performed demonstrating a 2 cm hyperdense homogeneous mass in the inferomedial aspect of the right orbit, with mild compression of the right eye (Figure 1(a)). The patient had no symptoms or signs of nasolacrimal duct obstruction. At the time of surgery a horizontal skin incision over the cyst was made and the cyst was exposed (Figure 1(b)). Upon further exposure, the cyst started to lose volume, and therefore ICG was injected into the cyst, which allowed improved visualization of the lesion boundaries (Figures 1(c) and 1(d)) permitting its complete excision (Figure 1(e)). The patient was treated twice a day with Maxitrol ointment (dexamethasone with polymyxin B and neomycin) over the surgical wound. Pathology examination identified complete excision of a cyst lined with epithelium of lacrimal duct origin. Postoperatively, the patient was asymptomatic and no cyst recurrence was noted.


Indocyanine green assisted removal of orbital lacrimal duct cysts in children.

Keren S, Dotan G, Leibovitch L, Selva D, Leibovitch I - J Ophthalmol (2015)

(a) Coronal CT scan showing a 2 cm homogenous inferomedial cystic mass in the right orbit. (b) Cyst exposure through a skin incision. (c) Intralesional injection of ICG. (d) Capsule demonstration and further exposure. (e) The completely excised cyst.
© Copyright Policy - open-access
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4302382&req=5

fig1: (a) Coronal CT scan showing a 2 cm homogenous inferomedial cystic mass in the right orbit. (b) Cyst exposure through a skin incision. (c) Intralesional injection of ICG. (d) Capsule demonstration and further exposure. (e) The completely excised cyst.
Mentions: One of the patients had a right inferomedial cystic lesion noted soon after birth. The patient was followed up regularly and when the lesion was growing considerably, an orbital CT was performed demonstrating a 2 cm hyperdense homogeneous mass in the inferomedial aspect of the right orbit, with mild compression of the right eye (Figure 1(a)). The patient had no symptoms or signs of nasolacrimal duct obstruction. At the time of surgery a horizontal skin incision over the cyst was made and the cyst was exposed (Figure 1(b)). Upon further exposure, the cyst started to lose volume, and therefore ICG was injected into the cyst, which allowed improved visualization of the lesion boundaries (Figures 1(c) and 1(d)) permitting its complete excision (Figure 1(e)). The patient was treated twice a day with Maxitrol ointment (dexamethasone with polymyxin B and neomycin) over the surgical wound. Pathology examination identified complete excision of a cyst lined with epithelium of lacrimal duct origin. Postoperatively, the patient was asymptomatic and no cyst recurrence was noted.

Bottom Line: Mean follow-up period was 9.3 months.Conclusion.Intraoperative injection of ICG into orbital cysts in children can aid surgeons in identifying cyst borders following inadvertent rupture, allowing complete removal.

View Article: PubMed Central - PubMed

Affiliation: Oculoplastic and Orbital Institute and Department of Ophthalmology, Tel Aviv Medical Center, 64239 Tel Aviv, Israel ; The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

ABSTRACT
Aim. To report on the use of indocyanine green (ICG) during surgical removal of pediatric orbital lacrimal duct cysts. Method. We conducted a retrospective review of our cases of surgical excision of orbital lacrimal duct cysts using intraoperative injection of indocyanine green (ICG), which was used following inadvertent cyst rupture and volume loss. The dye allowed complete cyst visualization and complete excision despite volume loss or cyst rupture. Results. The study included 6 children (3 boys, mean age of 4.2 ± 0.84 years, range 3-5 years). Mean follow-up period was 9.3 months. All cysts were located in the inferonasal quadrant of the orbit (4 in the right side). In all cases, ICG was injected into the cyst at the time of surgery following unintentional cyst rupture. After the dye injection, it was easy to identify the borders of the cyst, permitting complete cyst removal, without any intra- or postoperative complications. Pathological examination revealed that all cysts were of lacrimal duct origin. Conclusion. Intraoperative injection of ICG into orbital cysts in children can aid surgeons in identifying cyst borders following inadvertent rupture, allowing complete removal.

No MeSH data available.


Related in: MedlinePlus