Modified lateral orbitotomy with combined partial zygomatic arch and vertical ramus ostectomies for excision of a frontal and parietal bone osteoma in a dog

Abstract

Objective: To describe modifications to the lateral orbitotomy for surgical excision of tumors affecting the frontal, parietal, palatine, or temporal bones. Study design: Case report. Animal: A 5-year-old female spayed American pit bull terrier. Methods: The dog presented for excision of a bone tumor affecting the right frontal and parietal bones. A modified lateral orbitotomy was performed with combined partial zygomatic arch and vertical ramus ostectomies to increase working space and allow drilling of the calvarium ventral to the mass. Results: The dog tolerated the procedure well, and there were no complications from either the ostectomies or the craniectomy. Histopathological examination was consistent with complete excision of an osteoma. The dog survived 2 years with no recurrence and was euthanized due to an intestinal mass. Conclusion: The lateral orbitotomy approach can be modified with combined partial zygomatic arch and vertical ramus ostectomies to increase exposure and working space for resection of tumors affecting the frontal, parietal, palatine, or temporal bones.

Transorbital postcaruncular endoscopic surgery as an alternative to orbital exploratory surgery: A cadaveric study and case report in a dog with an orbital sarcoma

“…We describe a novel, minimally invasive approach to the orbital apex region in this cadaver study and clinical case report. In the clinical case, multiple surgical options to biopsy the orbital mass were considered 2,5‐7,9‐11 ; however, the owners were reluctant to adopt an orbital exploratory surgery or an exenteration without a histological diagnosis, so a transorbital endoscopy was elected. Intraoperative orbital ultrasound was used to confirm the location of biopsy sites because this technique was novel.…”

“…Surgical access to the orbit can be challenging because of the complex anatomy and delicacy of the orbital structures 1‐10 . To access the deep structures of the orbit, invasive techniques that involve osteotomy or ostectomy are often required 1,3‐7,9‐11 . Minimally invasive surgery is gaining popularity as a way to reduce surgical morbidity and improve visualization across many surgical subspecialties 12 .…”

The successful surgical removal of a massive maxillary palatine osteoma in a dog

“…Presenting signs include oral sensitivity or pain, reduced chewing, nasal discharge, facial swelling or facial asymmetry; however, many osteomas are incidental findings. 1,5,12 Maxillofacial osteomas have been reported in the maxillary, palatine, mandibular, zygomatic, fronto-parietal, nasal and lingual locations. 1,5,8,[12][13][14] Although osteomas are benign and generally slowly progressive, surgical excision is widely accepted as the treatment of choice, as their growth may become functionally intrusive or obstructive to surrounding structures.…”

“…1,5,12 Maxillofacial osteomas have been reported in the maxillary, palatine, mandibular, zygomatic, fronto-parietal, nasal and lingual locations. 1,5,8,[12][13][14] Although osteomas are benign and generally slowly progressive, surgical excision is widely accepted as the treatment of choice, as their growth may become functionally intrusive or obstructive to surrounding structures. 1 Excision of osteomas early in the disease process is recommended, as complete resection is curative; however, surgical debulking (cytoreduction) may be a palliative option for non-resectable lesions given their slow progression.…”

“…1,3 Surgical excision of osteomas is the treatment of choice with infrequent local recurrence if complete surgical margins are achieved. 1,[3][4][5] The purpose of this report is to present an unusual case of a massive palatine osteoma in a dog, to describe the intra-operative strategies used to achieve successful closure of the oral defect and to describe the post-operative clinical progression. The use of an angularis oris buccal mucosal interpolation flap, buccal mucosal rotational flap and rostral soft palate advancement have been described successfully in isolation; however, to the authors' knowledge, this is the first time they have been documented in combination.…”