Retrospective evaluation of canine palpebral masses treated with debulking and cryotherapy: 46 cases

Outcomes of Treatment of Eyelids and Third Eyelid Tumours in Dogs Using High-Frequency Radiowave Surgery

In human ophthalmology, the benefits of using high-frequency radiowave (HFR) electrocautery for surgical procedures were demonstrated and include effective haemostasis, shorter surgery times, and rapid recovery. In canine eyelid surgery, intraoperative bleeding is a common feature that may obscure the surgical field view and lead to the increased swelling of adjacent tissues, bruising, and pain. To evaluate the efficacy and benefits of HFR electrocautery in canine eyelid and third eyelid surgery, the medical records of 48 surgical excisions of eyelid tumours (involving up to one-third of the eyelid length) and 4 third eyelid excisions were reviewed. The information was collected including the breed, age, clinical signs, HFR power setting and mode of the surgical unit, electrode used for the surgery, intraoperative complications, histopathological diagnosis, and postoperative outcomes. Surgical techniques were performed using the Surgitron Dual 3.8 MHz Frequency RF device (Ellman International, Oceanside, NY, USA). Intraoperative bleeding was recorded as absent or very mild, and the surgical procedures were very fast. No complications occurred during the procedures. Healing within 10 days was observed in all the dogs. No tumour recurrences were recorded at the 12-month follow-up. HFR electrosurgery proved to be a safe, effective, and easy-to-perform technique for the removal of eyelid and third eyelid tumours in dogs.

Blepharitis and Neoplasms of the Canine Eyelid Margin and Skin

Canine eyelid masses (tumors) should include the differential clinical diagnoses of neoplasia and blepharitis. They have many common clinical signs including tumor, alopecia, and hyperemia. Biopsy and histologic examination remains the most effective diagnostic test to establish a confirmed diagnosis and appropriate treatment. Neoplasms are typically benign (tarsal gland adenomas, melanocytomas, and so forth) with the exception of lymphosarcoma. Blepharitis is noted in 2 age groups including dogs aged less than 1.5 years and middle aged to older dogs. Most blepharitis cases will respond to specific therapy once an accurate diagnosis is established.

Application of local anaesthesia and cryosurgery for eyelid masses in dogs

Background

Eyelid mass removal and cryotherapy application using only local anaesthesia and restraint may benefit patients with high anaesthesia risks.

Objective

To evaluate and validate cryosurgery application using the CryoPen XL^® on palpebral masses under local anaesthesia for patients not suitable for general anaesthesia.

Methods

Thirty patients underwent the procedure between November 2015 and April 2020. The procedure steps were as follows: skin preparation and local anaesthesia of the affected eyelid; debulking by resection and/or squeezing out the inspissated material; cryosurgery and post‐operative care using topical medication, antibiotics and anti‐inflammatory ointment. The medical records of the patients who underwent the operation were evaluated. Moreover, a telephonic survey with the pet owners was performed to determine recurrence, time to recurrence, survivability and side effects.

Results

Among the 30 owners, 29 responded to the survey. Ten (10/38, 26.3%) masses recurred with an average time to recurrence of 6.0 months. The estimated average depths for all, non‐recurred, and recurred masses were 1.89, 1.88 and 1.90 mm, respectively. The average recurrence rate and time to recurrence were higher and earlier, respectively, than previously reported values. However, no patient presented intra‐ or post‐operative complications.

Conclusion

These findings suggest that local anaesthesia and cryosurgery using the CryoPen XL^® can be used in patients with eyelid masses who are not suitable for general anaesthesia. Compared with the surgical eyelid mass removal and blepharoplasty procedure, the reported procedure is time‐ and cost‐effective, with the additional benefit of not requiring general anaesthesia.