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
