To present a new surgical technique for excision of orbital and periorbital cavernous hemangioma .

This retrospective study included patients with orbital cavernous hemangioma (CH) who were operated from 2001 to 2016 at our referral center. Epidemiologic data, symptoms, signs and images were reviewed from patients’ files with at least one year of follow up. Surgical results and complications were documented. We used “index finger decollation” technique without grasping the tumor for release of adhesions and its removal.

This study included 76 patients, of them 60 patients (%79) had orbital CH and 16 patients (%21) had periorbital CH. Orbital cases had mean age of 4012.1 (9-66) years consisting of 36(60%) female and 24 (40%) male patients. The main complaint was proptosis in 54 (90%) patients; average proptosis was 5.3 2 millimeters. In 35 (58.3%) patients, mean hyperopia of 1.11.8 (0.5 to 10) diopter as compared to other side was detected. The surgical approach was lateral orbitotomy in 49 (81.7%) patients, medial transcutaneous in 7 (11.7%) patients, inferior transconjunctival in 3 (5%) patients and in one (1.6%) patient simultaneous lateral and medial orbitotomy was performed. All tumors were removed intact, complications included ptosis in one case, lid retraction in one case and diplopia in two cases which all improved before 2 months. No optic nerve damage occurred. Periorbital cases had mean age of 31.615.1 years. 11 of them (%68.8) were female and 5 of them (%31.2) were male .In all cases complaint was periorbital lump. All of periorbital tumors were removed without complications.

“Index finger decollation” technique without grasping the tumor for excision of orbital cavernous hemangioma, via any external approach to the tumor is a safe technique with minimal complications.