Sclerosing therapy for orbital lymphangioma using sodium tetradecyl sulfate

Purpose: To describe the results of intralesional injection of the sclerosing agent sodium tetradecyl sulfate in patients with orbital lymphangioma. Methods: Four young patients with a history of orbital lymphangioma were treated on one or more occasions with percutaneous puncture and injection of sodium tetradecyl sulfate under computed tomography guidance. Resolution of the signs and symptoms, complications resulting from surgery, and recurrence of bleeding were studied. Results: Three patients with a long-standing history of unilateral proptosis and one patient with progressive unilateral visual loss from multiple recurrent orbital hemorrhages were studied. Treatment ranged from one to three sodium tetradecyl sulfate injections. All patients showed improvement of their signs and symptoms after treatment. A decrease in the size of lesions was demonstrated by orbital imaging. Visual acuity and intraocular pressure remained unchanged. Complications included transient postoperative localized inflammation in all cases and transient ophthalmoparesis in one patient. Follow-up time ranged between 15 and 36 months, during which no recurrence of bleeding was observed. Conclusions: Our study suggests that intralesional injection of sodium tetradecyl sulfate under computed tomography guidance is an effective treatment for patients with orbital lymphangioma and is not associated with vision-threatening complications.