Abstract
The junction of the bones of the orbit, caudal maxilla and zygoma intersect to form an anatomically intricate region known as the orbitozygomaticomaxillary complex (OZMC). Given the critical role of the OZMC in the structure, function and esthetics of the skull and midface, tumors in this region present unique challenges to the oromaxillofacial surgeon. Attempts to achieve histologically clean tumor margins in a cosmetically pleasing manner requires excellent intra-operative visualization. Additionally, minimized intra-operative and post-opertive complications is of paramount importance. In this manuscript we describe a combined intra- and extraoral approach to extensive tumors of the OZMC that incorporates orbital exenteration as a technique, which allows for excellent intra-operative visualization and mitigate intra- and post-operative complications. In addition, we describe our experience utilizing the technique in five clinical cases.
Highlights
Continuing with musculature closure caudally the orbicularis oris was apposed to the sphincter coli pars intermedia, followed by the rector anguli oculi and frontalis muscles apposed to the zygomaticus with 4-0 synthetic monofilament absorbable suture (Biosyn, Covidien) in a simple interrupted pattern
Instructions to feed only canned or softened kibble and to avoid toys or mouth play were given to the owners
In the report conveyed here, we have described a surgical technique to resect extensive orbitozygomaticomaxillary complex (OZMC) tumors in which an intraoral approach is combined with a horizontal extraoral incision along the dorsolateral muzzle and zygoma that incorporates a transpalpebral approach to orbital exenteration
Summary
The degree to which a tumor of the OZMC has invaded orbital and periorbital structures may be uncertain. In such situations, a surgical approach to OZMC tumors that combines an intra- and extraoral approach with transpalpebral exenteration may be utilized. Transpalpebral exenteration is a modification to a previously reported technique [6, 7] that facilitates surgical excision of tumors significantly involving the medial orbit. We describe this approach to OZMC tumors and report our clinical experience in five dogs. To the authors’ knowledge, such an approach has not previously been described in the peer-reviewed English language literature
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