Zusammenfassung
Orbitale Erkrankungen kommen im Säuglings- und Kindesalter relativ häufig vor, wie
z. B. Fehlbildungen der Orbita im Rahmen von kraniofazialen Syndromen, gutartige und
bösartige Raumforderungen. Aber auch entzündliche und infektiöse Erkrankungen und
Verletzungen treten in dieser Altersgruppe auf. Dieser Beitrag gibt einen Überblick
über die wichtigeren klinischen und differenzialdiagnostischen Orbitaerkrankungen
im Kindesalter.
Abstract
Orbital disorders in childhood include various pathologies. Whereas neoplastic lesions
and structural anomalies (which frequently cause strabismus) predominate in newborns
and infants, vascular lesions become more common in toddlers. Inflammatory lesions
are less common than in adults and affect mostly older children and adolescents. The
most common orbital mass in infants and young children is a dermoid cyst, a benign
lesion.
Rhabdomyosarcoma as the most common primary orbital malignancy and neuroblastoma as
a common metastasis to the orbit should be considered in children with new onset orbital
space-occupying lesions.
Capillary hemangioma and lymphangioma (lymphatic malformation) are relatively common
vascular orbital lesions in children. Novel therapeutic options include systemic betablockers
for capillary hemangioma and sirolimus for lymphangioma. In contrast to adults, external
signs of an orbital fracture may be absent or mild in children. If ocular motility
restriction after orbital trauma is present in a child without obvious external signs,
a „white-eye blowout fracture“ of the orbit should be considered and requires prompt
surgical repair if present.
Inflammatory disorders of the orbit such as thyroid-related orbitopathy and idiopathic
orbital inflammation are uncommon in young children and occur more frequently in adolescents.
In young children, amblyopia may complicate any orbital disease. It should be treated
using part-time occlusion or pharmacologic penalisation of the fellow eye and the
underlying cause should be addressed.
Schlüsselwörter
Kinder - Orbita - Erkrankung - Anomalie - Amblyopie
Key words
children - orbit - disorder - anomaly - amblyopia
