Biopsy of granulomatous lacrimal gland inflammation
Richard C. Allen, MD, PhD, FACS
Additional Notes: Length 01:54
Posted February 10, 2017
This is Richard Allen at the University of Iowa. This video demonstrates a lacrimal gland biopsy in a patient with an enlarged lacrimal gland. The video is a good representation of sarcoid granulomas in the lacrimal gland. A 4-0 silk suture is placed through the upper eyelid at the level of the tarsus to provide traction. An incision is then made along the upper eyelid crease and a small blepharoplasty marking. Dissection is then carried out between the orbicularis muscle and the orbital septum to the superior orbital rim. The orbital septum is then opened and the granulomas are demonstrated in the area of the lacrimal gland. A biopsy is performed with Westcott scissors of the granulomas. The specimen is sent to the pathologist for evaluation. In this patient, the diagnosis of sarcoid was confirmed with the biopsy as well is an elevated ACE level. Additional specimens are taken. Again, the inflammatory nodules consistent with granulomas are noted. Hemostasis is obtained with bipolar cautery. The upper eyelid crease incision is then closed with interrupted 6–0 Prolene sutures.
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