How is orbital leiomyoma caused?

summary

Leiomyoma is a benign tumor composed of smooth muscle cells. Most of them occur in the tissues and organs containing smooth muscle, such as uterus and gastrointestinal tract. Primary orbital involvement is rare and has been reported as a single case in the past. How is orbital leiomyoma caused?

How is orbital leiomyoma caused?

There are two parts of orbital smooth muscle: orbital smooth muscle and vascular smooth muscle. Orbital smooth muscle includes M ü The orbital muscle and the periocular muscle of the eye. M ü The muscle of M ü The muscle is a fan-shaped thin layer of smooth muscle fibers distributed in the periosteum of the superior and inferior orbital fissure. It is connected with the inferior oblique muscle forward above the orbital floor. The other part of the fibers reached the fat of cavernous sinus and pterygopalatine fossa. A thin layer of smooth muscle fibers around the anterior half of the eyeball was found around the eyeball, with a width of 3-7mm and unclear boundary. Angioleiomyoma may originate from the smooth muscle layer of small vessels (mainly the internal orbital vein), so it is also called angioleiomyoma. The following two facts support this conclusion: ① there are more blood vessels in the orbital apex, leiomyomas mostly occur in the orbital apex, and tumors in the anterior part of the orbit are mostly related to the upper eyelid ü It's not about the Keller muscle. ② There are many blood vessels in the tumor. The tumor cells grow around the blood vessels and are arranged like onion. The cells are closely connected with the blood vessels. Histology can provide the basis for the occurrence of the tumor in the blood vessels.

Common symptoms: blurred vision, visual impairment and exophthalmos are different according to the primary location of the tumor. The tumor occurred in the orbital apex, first complained of vision loss, even only light perception, sometimes misdiagnosed as retrobulbar optic neuritis. Some patients had exophthalmos, and most of them were progressive axial. When the orbital pressure is high, the eyeball cannot be retracted. The posterior wall of the eyeball was flat, even protruding into the vitreous cavity, retinal edema, macular degeneration or choroidal folds, optic disc atrophy or edema. Eye movement was limited in one or more directions. If the tumor only occurs in the anterior part of the orbit, the eyeball can shift to one side without exophthalmos. Palpable tumor, hard, smooth surface, no tenderness, can push.

Orbital leiomyoma is not sensitive to radiation and drug therapy. Surgical resection is the main treatment. The tumors located in the anterior part of the orbit can be completely removed through the skin incision or conjunctival incision at the orbital margin. The tumors located behind the bulbar can be removed through lateral orbitotomy. Because there are many adhesion at the back end of the tumors and it is difficult to separate them, intracapsular excision technique can be used. First, isolate the anterior tumor, surround it with saline gauze and separate it from the normal structure, The orbital apex was dissected and excised completely under direct vision. The prognosis of patients with complete resection is good and there is no recurrence. However, because leiomyomas are mostly located in the orbital apex, the operation may cause visual impairment or other complications.

matters needing attention

1. Mainly pay attention to the usual living habits, timely discovery and timely treatment, will not cause too much impact on their own body. 2. Keep your mind at peace. Don't be angry in spring. Don't be too impatient. Always keep calm. 3. Quit smoking, drink less and have coffee. Smoking is most likely to damage the surface barrier of respiratory tract and induce disease attack. Tobacco, alcohol and coffee can stimulate nerve excitement, some people want to "eliminate tension and fatigue", but actually weaken the body's disease resistance. 4. Keep away from allergens and crowded places. 5. Diet should be light, nutritious and easy to digest, eat less greasy fried and spicy food.