Biopsy of extraocular muscle
CPT4 code
Name of the Procedure:
Biopsy of Extraocular Muscle
(also known as Extraocular Muscle Biopsy)
Summary
A biopsy of the extraocular muscle involves taking a small tissue sample from one of the muscles that control eye movement. This procedure is performed to diagnose underlying conditions affecting these muscles.
Purpose
The biopsy is used to diagnose various medical conditions affecting the extraocular muscles, such as inflammatory diseases, infections, or muscle tumors. The goal is to obtain a tissue sample that can be examined under a microscope to identify the specific cause of muscle abnormalities.
Indications
- Chronic eye muscle weakness or paralysis
- Suspected inflammatory or infectious myopathies
- Unexplained ocular pain or swelling
- Diagnostic clarification for muscle tumors
Preparation
- Fasting for a few hours before the procedure may be required.
- Adjustments to current medications, especially anticoagulants, might be necessary.
- Pre-procedure assessments like blood tests or imaging scans to plan the biopsy.
Procedure Description
- The patient is placed in a comfortable position, usually lying down.
- Local anesthesia is administered to numb the area around the targeted extraocular muscle.
- A small incision is made over the muscle.
- Specialized instruments are used to carefully extract a small tissue sample from the muscle.
- The incision is closed with sutures and a sterile bandage is applied.
- The tissue sample is sent to a pathology lab for analysis.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
The biopsy is performed in a hospital or outpatient surgical center.
Personnel
- Ophthalmologist or specialized surgeon
- Surgical nurse
- Anesthesiologist (if sedation is required)
Risks and Complications
- Infection at the biopsy site
- Bleeding or hematoma formation
- Scarring or damage to the muscle
- Transient double vision or eye movement issues
- Allergic reactions to anesthesia
Benefits
- Accurate diagnosis of muscle-related conditions
- Tailored treatment plan based on specific diagnosis
- Early intervention for muscle diseases
Recovery
- Post-procedure instructions may include rest and limited eye movement.
- Pain management with over-the-counter pain relievers.
- Follow-up appointments to monitor healing and review pathology results.
- Most patients can resume normal activities within a few days, although heavy lifting and strenuous activities should be avoided until fully healed.
Alternatives
- Blood tests or imaging studies (e.g., MRI) as non-invasive diagnostic options.
- Electromyography (EMG) for functional assessment of the muscles.
- Each alternative has its own pros and cons regarding accuracy and invasiveness compared to a biopsy.
Patient Experience
The patient may feel slight pressure or discomfort during the injection of local anesthesia. Post-procedure soreness and mild bruising around the incision site are common and can be managed with painkillers and ice packs. Full visual and physical recovery is expected within a week.