Video-endoscope assisted teaching during sub-periosteal orbital surgery.
OBJECTIVE
The authors report the novel use of the video-endoscope as an adjunct in teaching orbital surgery, in particular within the sub-periosteal orbital space. This is of most use during situations where visualisation is of critical importance and direct supervision is not possible.


METHODS
This technique was used for 16 cases of orbital surgery during a 12-month period. There were 5 orbital fracture repairs, 8 orbital decompressions (4 via a swinging eyelid and 4 via a transcaruncular approach), an infraorbital nerve biopsy, an eosinophilic granuloma and an orbitofrontal cholesterol granuloma. All procedures were performed by the trainee under consultant supervision with the endoscope being used when direct visualisation was not possible for the consultant. A rigid Storz 3-chip video-endoscope with 0, 30 and 70-degree tips was used to enable visual supervision.


RESULTS
The endoscope was of particular use in procedures involving the posterior orbital floor, orbital roof and medial orbital wall. It also enabled safe supervision of curettage of an orbital roof lesion which abutted the dura. The technique was easy to use; it provided good local illumination and a magnified view for supervision.


CONCLUSIONS
This technique is a valuable adjunct in allowing the trainee to safely perform selected complex orbital surgery under video-endoscopic supervision.
Malhotra
Raman
R
Oculoplastic and Orbital Unit, Department of Ophthalmology, Royal Adelaide Hospital, University of Adelaide, Adelaide, Australia.
Selva
Dinesh
D
Wormald
Peter J
PJ
Davis
Garry
G
D004724:Endoscopy / Q000193:education / Q000379:methods; D005128:Eye Diseases / Q000601:surgery*; D006801:Humans; D013508:Ophthalmologic Surgical Procedures / Q000193:education* / Q000379:methods; D009915:Orbit / Q000601:surgery*; D009917:Orbital Fractures / Q000601:surgery*; D020535:Video-Assisted Surgery / Q000193:education* / Q000379:methods