A surgical approach for extensive orbital exenteration in dogs; a description of technique and its application in 4 cases

Objective To describe a surgical approach for preplanned orbital exenteration. Animals studied Indications included intraconal orbital mass lesions. Four dogs were included, 3 with neoplasia and one with retro bulbar nodular fasciitis. Procedure To facilitate complete removal of lesions, exenteration was performed by a new procedure for wide access. The frontalis and temporalis muscles were elevated and retracted through a single U-shaped skin incision. Zygomatic arch osteotomy was performed, followed by a 360-degree peritomy and zygomatic process osteotomy. The eyelids were divided from each other through the lateral cantus and then folded forward to expose the globe. The orbit was exenterated by blunt and sharp dissection. Osteotomies were closed with cerclage wires, soft tissues closed and the skin wound sutured in a T-shape. Results The present exenteration procedure gave excellent access to remove orbital contents flush with the optic foramen and orbital fissure. Postoperative swelling and pain were limited and healing uneventful. Two of the 3 neoplasia cases experienced tumor recurrence involving the brain at 18 and 20 months postoperatively, respectively. Both of these had optic canal or intracranial tumor extension preoperatively. Long-term complications included mild concavity of the operated side of the face. Conclusions The present approach for preplanned exenteration offers excellent access for complete removal of orbital contents to the level of the optic foramen. Complications due to the surgical method are few and limited.