Designing a Novel Approach to Cadaveric Dissection and Evaluation of the Lacrimal Gland Anatomy

During our study, the orbital dissections of 44 cadavers were analyzed, and the lacrimal gland's condition after dissection was evaluated. Medical students previously dissected twenty-two of the cadavers using the dissection steps outlined in Grant’s Dissector. From these, 21 student groups performed orbital dissection using the two approaches outlined in Grant’s Dissector. Post-evaluation of Grant’s anterior approach (GAA) showed that 50% of the lacrimal glands had signs of damage to the orbital lobe, and 88.89% of the palpebral lobe were damaged. When Grant’s supraorbital approach (GSA) was used, 70% of the palpebral lobes showed signs of damage compared to the 35% of orbital lobes. Grant’s dissection steps were reviewed to analyze the steps that could lead to possible damage. The concerns from these steps were listed, and some adaptations were made for further dissections. Fourteen cadavers were used for phase 1 dissections to find methods to lessen damage to the lacrimal gland during dissection. After various attempts to make minor adaptations to the Grant’s approach, a novel approach was formed. The McDowell-Peters approach evolved along with two adaptations of this method. This novel approach, along with the Grant’s Dissector approaches were further analyzes phase 2 dissections which 8 cadavers to compare the Grant’s Dissector approaches to the McDowell-Peters’ approaches. The overall preservation rates of the lacrimal glands were calculated and statistically analyzed for the various approaches. The overall McDowell-Peters approach (OMPA) had a higher rate of preserving the palpebral lobe and orbital lobes both individually and together in each dissection. Analysis showed that the difference in preservation rate was statistically significant when the OMPA was compared to each of the other overall approaches.