Cornell University College of Veterinary Medicine, Ithaca, New York.
Vet Surg. 2020 Oct;49(7):1359-1366. doi: 10.1111/vsu.13446. Epub 2020 Jun 3.
To describe a postcaruncular approach for transorbital endoscopy as an alternative, minimally invasive technique to access the orbital apex.
Ex vivo and prospective clinical case report.
A 12-year-old male castrated cocker spaniel and three cadaver heads (one large breed dolichocephalic, one medium-sized breed mesocephalic, and one small breed brachycephalic).
Transorbital endoscopy was performed to obtain biopsies of an orbital apex mass by using a postcaruncular approach. A 2.7-mm 30° rigid endoscope fitted with a cystoscope working sheath was used with the aid of a blunt suction-dissector and fluid ingress. This procedure was first performed on three cadavers to assess feasibility and later performed in a clinical case.
By using a transorbital postcaruncular approach, it was possible to visualize and obtain biopsies from structures within the orbital apex with minimal perioperative morbidity. Dissection and expansion of the working space was facilitated with the aid of fluid ingress; however, judicious use of fluids is recommended because secondary orbital edema and chemosis can occur.
Transorbital endoscopy via a postcaruncular approach is feasible.
This technique should be considered in cases in which a histological diagnosis is required prior to definitive treatment as a method to obtain biopsy samples of the orbital apex region without major surgical dissection.
描述一种经眼窝后入路眶尖内窥镜检查方法，作为一种替代的微创技术，以进入眶尖。
离体和前瞻性临床病例报告。
一只 12 岁雄性去势可卡犬和三个头颅标本（一个大型长头犬，一个中型短头犬，一个小型短头犬）。
经眼窝后入路行眶尖内窥镜检查，以获得眶尖肿块的活检标本。使用 2.7mm 30°刚性内窥镜和膀胱镜工作鞘，借助钝性吸引剥离器和液体进入来进行操作。该程序首先在三个头颅标本上进行，以评估其可行性，然后在临床病例中进行。
通过经眼窝后入路，可以在最小的围手术期发病率的情况下可视化和获得眶尖内结构的活检标本。通过液体进入来辅助解剖和扩大工作空间；然而，建议谨慎使用液体，因为可能会发生继发性眶周水肿和球结膜下出血。
经眼窝后入路的眶尖内窥镜检查是可行的。
在需要明确治疗前进行组织学诊断的情况下，应考虑这种技术作为一种不进行主要手术解剖即可获得眶尖区域活检样本的方法。
