Freitag Suzanne K, Yoon Michael K, Callahan Alison B, Lee N Grace, Lefebvre Daniel R
Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School , Boston, Massachusetts 02114 , USA.
Orbit. 2014 Jun;33(3):189-92. doi: 10.3109/01676830.2014.900086. Epub 2014 Mar 28.
To report the novel use of a sinus microdebrider for the removal of tissue during orbital surgery.
This retrospective study reviewed the logs of 3 surgeons to identify patients who required orbital surgery during which the surgeon chose to use a sinus microdebrider with an open sky technique as a means of removing portions of the orbital tissue. Collected data included patient demographics, clinical examinations, pathologic diagnoses, radiologic studies, operative reports and, when available, photographs and intra-operative video.
Three patients were identified as having undergone orbital surgery assisted by the use of a sinus microdebrider. The first patient had an extensive, recurrent left orbital myxoid tumor. Debulking of this gelatinous, infiltrative mass was aided by the combined suction and cutting action of the microdebrider. Two cases involved orbital exenteration for infiltrative sino-orbital fungus infection resulting in a blind eye and frozen globe. Removal of orbital apical tissue during exenteration surgery was facilitated with the microdebrider.
The characteristics of the sinus microdebrider make it a useful adjunct for orbital surgery, particularly in situations where tissue may be difficult to grasp and excise. Caution should be exercised whenever using this electrically powered tool due to its potential for rapid tissue destruction. Therefore, the microdebrider should only be used in cases in which there is little risk of damage to essential orbital structures.
报告鼻窦微型清创器在眼眶手术中用于组织切除的新用途。
这项回顾性研究查阅了3位外科医生的记录,以确定那些需要进行眼眶手术的患者,在手术中外科医生选择采用开放式手术技术使用鼻窦微型清创器作为切除部分眼眶组织的一种手段。收集的数据包括患者人口统计学资料、临床检查、病理诊断、影像学研究、手术报告,以及如有可用的照片和术中视频。
确定有3例患者在鼻窦微型清创器辅助下接受了眼眶手术。首例患者患有广泛复发性左眼眶黏液样肿瘤。微型清创器的抽吸和切割联合作用有助于清除这种凝胶状浸润性肿块。另外2例是因浸润性鼻窦眼眶真菌感染导致失明和眼球固定而进行的眼眶内容物剜除术。微型清创器便于在眼眶内容物剜除术中切除眶尖组织。
鼻窦微型清创器的特性使其成为眼眶手术的一种有用辅助工具,尤其是在组织可能难以抓取和切除的情况下。由于其有造成组织快速破坏的可能性,使用这种电动工具时应谨慎。因此,微型清创器仅应在对重要眼眶结构造成损伤风险较小的情况下使用。