SURGICAL EXCISION OF PERIORBITAL CAPILLARY HEMANGIOMAS

Background: Periorbital capillary hemangiomas of childhood can produce ptosis, strabismus, and anisometropia, resulting in amblyopia. Tradit ional therapy with either systemic or focal corticosteroids occasional ly yields incomplete resolution of these lesions and may be associated with numerous adverse complications. The authors report their experie nce performing surgical resection of periorbital capillary hemangiomas . Methods: Twelve children with periorbital capillary hemangiomas were treated surgically. Six of these children had previously failed to ad equately respond to steroid injections and six were primarily treated with surgical resection. All lesions were believed to be localized and did not appear to be infiltrative on preoperative computed tomographi c scans. Results: All lesions were completely resected, except for two in which there was a small area of residual hemangioma surrounding th e lacrimal drainage system that was left intact. Controlled intraopera tive hemorrhage in two patients required intraoperative directed-donor blood transfusion. Perioperatively, in one patient a wound dehiscence developed, which required minor repair. This same patient elected to have surgical scar revision postoperatively. The patients have been fo llowed up to 5 years. All did well with improved cosmesis, and they ha ve good lid function. No recurrences have been noted. Conclusion: Surg ical resection of pediatric capillary hemangiomas should be considered a treatment option in those that fail to respond to corticosteroids a nd/or are isolated and noninfiltrative in nature.