What is orbital tumor removal surgery?
Orbital tumor removal surgery is a procedure performed to diagnose and treat abnormal growths within the orbit, the bony cavity behind and around the eye. Because the orbit is a compact, enclosed space, even a small mass can affect vision, eye movement, and the position of the eye, making accurate diagnosis and appropriate treatment essential.
Orbital tumor surgery may involve a biopsy, in which a small sample of tissue is removed and examined under a microscope to identify the type of growth, full removal of the tumor, or both depending on the situation. In some cases, a biopsy is performed first to confirm the diagnosis before a decision is made about removal. In others, the tumor is removed entirely in a single procedure.
Who needs orbital tumor surgery?
Surgery is recommended when:
- A mass in the orbit is causing symptoms such as a bulging eye, double vision, vision changes, eyelid drooping, or pain and pressure around the eye
- Imaging studies have identified a tumor or mass that needs to be characterized through tissue sampling
- A benign tumor has grown large enough to affect vision, eye position, or comfort
- A malignant tumor requires surgical removal as part of a broader treatment plan
- A suspected tumor cannot be conclusively diagnosed through imaging alone and requires a biopsy to determine the appropriate course of treatment
Some small, slow-growing benign tumors that are not affecting vision or eye function may be monitored over time rather than removed immediately. Your surgeon will discuss whether observation or surgical intervention is the right approach for your situation.
What should I expect during orbital tumor surgery?
Prior to surgery, you will meet with your oculofacial plastic surgeon for a thorough evaluation. During this appointment, your surgeon will:
- Review your symptoms, their timeline, and any relevant medical history, including any prior cancer diagnosis
- Examine the eye, eyelids, and orbit for changes in position, movement, and appearance
- Review imaging studies, including computed tomography (CT) and magnetic resonance imaging (MRI), to assess the size, location, and characteristics of the mass
- Discuss whether biopsy alone, full tumor removal, or a combination of both is most appropriate
In some cases, coordination with other specialists such as neurosurgery or ear, nose, and throat (ENT) surgeons may be recommended before surgery, depending on the tumor's location and complexity.
Orbital tumor surgery is performed under general anesthesia for most cases, though simple biopsies of tumors located toward the front of the orbit may sometimes be performed under local anesthesia with sedation. Both are outpatient procedures in most cases, meaning you go home the same day.
The surgical approach depends on where the tumor is located within the orbit:
- Anterior orbitotomy accesses tumors near the front of the orbit through a small incision in the eyelid, eyelid crease, or inner corner of the eye with minimal disruption to surrounding tissue.
- Lateral orbitotomy is used for tumors located deeper within the orbit. A small section of the outer bony wall is temporarily removed to reach the tumor and replaced once the procedure is complete.
- Transconjunctival or medial approach accesses the orbit through the inner lining of the eyelid or inner corner of the eye for tumors along the inner wall of the orbit.
- Combined approach may be used for complex tumors near the skull base, with an oculofacial plastic surgeon working alongside neurosurgery or ENT specialists.
Once the tumor is accessed, it is either removed in its entirety or a tissue sample is taken for biopsy and sent to a pathologist to determine the exact type of growth. The incision is then carefully closed with sutures, with the goal of preserving surrounding healthy tissue and restoring normal anatomy.
What are the risks of orbital tumor surgery?
Orbital tumor surgery is a well-established procedure performed by surgeons with specialized training in the orbit and surrounding structures. As with any surgical procedure, there are potential risks to be aware of:
- Bleeding or infection
- Scarring
- Incomplete tumor removal
- Changes in vision or double vision
- Damage to the optic nerve or surrounding structures
- Asymmetry in eyelid or eye position
- Recurrence of the tumor
Your surgeon will discuss the specific risks relevant to your procedure before surgery.
The oculofacial plastic surgeons at The Iowa Clinic evaluate and treat a full range of orbital masses, coordinating with other specialties when needed to provide a thorough, individualized plan of care. Call 515.875.9480 to schedule an appointment.