VOL. 74, NO. 6 NOTES, CASES, INSTRUMENTS 1211 trieval) is not new ; it has been employed in military aerial photography for at least 10 years. However, to our knowledge, its use for fluorescein angiography is new. This 35 mm black and white positive film, with an ASA number of 320, is commercially available in 150-foot rolls. The roll is hand-loaded into standard 35 mm film cassettes, and yields about 30 rolls of 36 exposures. The cost of each roll is about 67 cents (compared with Tri-X at 86 cents). Once the fluorescein angiogram has been taken with a fundus flash II camera at a power setting of "high," the exposed film can be developed in about 30 minutes using Kodak direct positive film developing kit. The dry, positive film strip may then be projected, using any standard adaptor (for example, Ektagraphic film strip adaptor, AV425) attached to any standard carousel projector. The filing of the angiograms is accomplished by cutting a roll into seven strips and placing the strips into an 8 X 10 inch transparent film strip holder. Subsequent study of the angiogram may be accomplished with the strips remaining in the transparent holder. SUMMARY Kodak 2498 RAR (rapid access retrieval) film eliminates processing a negative film strip and permits finished angiograms in 30 minutes. The film is commercially available in 150-foot rolls. PERIOSTEAL ELEVATOR FOR ORBITAL SURGERY RICHARD R. TENZEL, M.D. North Miami Beach, Florida There is no single periosteal elevator that meets all the criteria for orbital surgery. Frequently, one needs to enlarge the periosteal incision on the orbital rim, and this requires a sharp, firm cutting edge. The periosteum at the orbital rim is firmly adherent and is difficult to separate from the bone, whereas the periosteum is easily separated once it is elevated over the rim and into the orbit. As it is desireable to keep the periosteum intact, a flat spatula blade is necessary for the latter part of the dissection. In orbital fractures, a flat thin blade is also the instrument of choice to gently free any orbital contents from fracture entrapment. One end of the elevator described here* (Fig. 1) has a sturdy cutting head for cutting periosteum and separating its firm attachments from the bone. The diameter of the handle is sufficient to minimize finger fatigue during the course of surgery. The other end has a thin, blunt spatula blade. SUMMARY A new periosteal elevator meets the various criteria for surgery involving the orbital periosteum. It has both a thin, flat spatula blade as well as a sharp, firm cutting head and the handle is comfortable for this type of surgery. Fig. 1 (Tenzel). Periosteal elevator. Reprint requests to Richard R. Tenzel, M.D., 1100 Northeast 163rd Street, North Miami Beach, Florida 33162. * Available from Storz Instrument Company- ( Model E-4595).

Periosteal Elevator for Orbital Surgery

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Page 1: Periosteal Elevator for Orbital Surgery

VOL. 74, NO. 6 NOTES, CASES, INSTRUMENTS 1211

trieval) is not new ; it has been employed in military aerial photography for at least 10 years. However, to our knowledge, its use for fluorescein angiography is new.

This 35 mm black and white positive film, with an ASA number of 320, is commercially available in 150-foot rolls. The roll is hand-loaded into standard 35 mm film cassettes, and yields about 30 rolls of 36 exposures. The cost of each roll is about 67 cents (compared with Tri-X at 86 cents).

Once the fluorescein angiogram has been taken with a fundus flash II camera at a power setting of "high," the exposed film can be developed in about 30 minutes using Kodak direct positive film developing kit. The dry, positive film strip may then be projected, using any standard adaptor (for example, Ektagraphic film strip adaptor, AV425) attached to any standard carousel projector. The filing of the angiograms is accomplished by cutting a roll into seven strips and placing the strips into an 8 X 10 inch transparent film strip holder. Subsequent study of the angiogram may be accomplished with the strips remaining in the transparent holder.

SUMMARY Kodak 2498 RAR (rapid access retrieval)

film eliminates processing a negative film strip and permits finished angiograms in 30 minutes. The film is commercially available in 150-foot rolls.

PERIOSTEAL ELEVATOR FOR ORBITAL SURGERY

RICHARD R. TENZEL, M.D.

North Miami Beach, Florida

There is no single periosteal elevator that meets all the criteria for orbital sur

gery. Frequently, one needs to enlarge the periosteal incision on the orbital rim, and this requires a sharp, firm cutting edge. The periosteum at the orbital rim is firmly adherent and is difficult to separate from the bone, whereas the periosteum is easily separated once it is elevated over the rim and into the orbit. As it is desireable to keep the periosteum intact, a flat spatula blade is necessary for the latter part of the dissection. In orbital fractures, a flat thin blade is also the instrument of choice to gently free any orbital contents from fracture entrapment.

One end of the elevator described here* (Fig. 1) has a sturdy cutting head for cutting periosteum and separating its firm attachments from the bone. The diameter of the handle is sufficient to minimize finger fatigue during the course of surgery. The other end has a thin, blunt spatula blade.

SUMMARY

A new periosteal elevator meets the various criteria for surgery involving the orbital periosteum. It has both a thin, flat spatula blade as well as a sharp, firm cutting head and the handle is comfortable for this type of surgery.

Fig. 1 (Tenzel). Periosteal elevator.

Reprint requests to Richard R. Tenzel, M.D., 1100 Northeast 163rd Street, North Miami Beach, Florida 33162.

* Available from Storz Instrument Company-( Model E-4595).