Piezosurgery as a minimally invasive approach in lateral orbitotomy in orbital tumor resection
Journal Title: Annales Academiae Medicae Silesiensis - Year 2014, Vol 68, Issue 5
Abstract
INTRODUCTION Total resection of orbital tumors with a view to improve and preserve vision and eye movement should be the goals of treatment. Orbital tumors are removed through the fronto-orbital approach or lateral orbitotomy with the use of a high-speed drill for bone cutting. However, this technique may cause bone tissue loss and poor cosmetic results, especially if the orbital rim is damaged. The aim of the study was to evaluate the piezosurgery technique as a minimally invasive approach in lateral orbitotomy and to assess its impact on the obtained cosmetic results. MATERIALS AND METHOD Over a period of two years, seven patients with various orbital tumors underwent lateral orbitotomy with the use of piezosurgery. The exact location of the tumors was confirmed by MRI. Piezosurgery is active only in mineralized tissue. With a saw thickness of only 0.5 mm, this method facilitates a very gentle and safe cut of the bone, with no damage to the dura mater, vessels or nerves. Orbital bone reconstruction was performed with the mini plate method. The outcome and the obtained cosmetic results were assessed between 6 to 25 months after surgery. RESULTS Piezosurgery offered a greater surgical access than the classic method. This facilitated safe dissection and total resection of orbital tumors with only slight prolongation of surgery time compared to high speed drill osteotomy. No damage to the dura mater or postoperative CSF leaks were observed. Reconstruction of the orbital bone was much easier and more efficient, with very good and excellent long-term cosmetic results in all the patients. CONCLUSIONS The use of piezosurgery in lateral orbitotomy offers very good and minimally invasive orbital access as well as excellent long-term cosmetic results.
Authors and Affiliations
Stanisław Hendryk
Keywords
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