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A. K. Thiagarajasubramanian, M. Lubow, B. Schultz, D. M. Grzybowski; Transcranial Orbitotomy for Ocular-Orbital Histopathology: The FULL Autopsy Is Not Full Enough. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3515.
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Orbital tissues are not routinely accessible at autopsy, although they could show systemic pathology. This procedure accesses important ocular/orbital tissues by a transcranial-orbital approach for study. Obtained tissues include the posterior globe, optic nerve, and adjacent structures, while leaving behind anterior structures and so preserving the decedent’s external appearance for display and burial procedures.
This technique as shown in our sequence of images was developed at autopsies conducted at our university morgue. Literature was reviewed for topics pertinent to these ocular and orbital tissues, and to consider pathology that might be missed by neglecting them.
We have successfully developed and demonstrated a previously unpublished technique that gives access to ocular-orbital tissues including not only retina, choroid, sclera, and optic nerve, but also important blood vessels, muscles, and more, under consent for the "full autopsy." This technique leaves no marks on the decedent’s face, while satisfying ceremonial and scientific demands. The attached image shows the end-result and the intact facial appearance of the deceased.
The scientific and clinical information inherent in these tissues, newly available, could now benefit clinicians and investigators. This transcranial approach resolves legal, ceremonial, and emotional concerns while permitting access to tissues that exhibit ocular and orbital signs of local and systemic disease. With this technique, each autopsy is an opportunity for new information.
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