Orbital Compartment Syndrome: Alternative Tools to Perform a Lateral Canthotomy and Cantholysis.

TitleOrbital Compartment Syndrome: Alternative Tools to Perform a Lateral Canthotomy and Cantholysis.
Publication TypeJournal Article
Year of Publication2016
AuthorsIserson KV, Luke-Blyden Z, Clemans S
JournalWilderness Environ Med
Volume27
Issue1
Pagination85-91
Date Published2016 Mar
ISSN Number1545-1534
Abstract

Orbital compartment syndrome acutely threatens vision. Lateral canthotomy and cantholysis ameliorate the compartment syndrome and, to save a patient's vision, must be performed in a timely manner. This requires appropriate tools. In resource-poor settings, the straight hemostat and iris scissors that are generally used for this procedure may be unavailable. In such situations, safe alternatives include using a multitool in place of a hemostat and a #11 scalpel blade instead of the iris scissors. As when using hemostats of varying sizes, the pressure applied to the multitool must be carefully modulated. When using a scalpel blade for the lateral canthotomy, the hemostat arm remains beneath the lateral canthus as a "backstop" to protect deeper tissues. For the cantholysis, use the back of the blade to "strum" for the ligaments, reversing its direction only to cut the ligament when it is identified.

DOI10.1016/j.wem.2015.09.002
Alternate JournalWilderness Environ Med
PubMed ID26585073
Faculty Reference: 
Kenneth V. Iserson, MD, MBA, FACEP