Effect of orbital wall resection areas in the treatment of patients with endocrine orbitopathy |
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| Institution: | 1. Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany;2. Department of Surgical Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait;3. Faculty of Mechanical and Energy Engineering, University of Applied Sciences (HTWK), Karl- Liebknecht Str. 145, 04277 Leipzig, Germany;4. Department of Ophthalmology, Leipzig University, Liebigstraße 12, 04103 Leipzig, Germany;1. University of Glasgow Medical School, University Avenue, Glasgow G12 8QQ, United Kingdom;2. Consultant Maxillofacial Head & Neck Surgeon, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, 1345 Govan Road, Glasgow G51 4TF, United Kingdom;3. University of Glasgow Dental School, 378 Sauchiehall Street, Glasgow G2 3JZ, United Kingdom;4. Specialty Registrar in Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, 1345 Govan Road, Glasgow G51 4TF, United Kingdom;1. Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glueckstrasse 11, D-91054 Erlangen, Germany;1. GSR Hospital, Hyderabad, Telangana, India;2. Department of Otorhinolaryngology, Head & Neck Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands;3. Sri Sai College of Dental Surgery, Department of Oral and Maxillofacial Surgery, Vikarabad, Telangana, India;4. Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands;5. Dept. Of Cranio-maxillofacial Surgery, AIIMS, Rishikesh, Uttarakhand, India;1. Centre de chirurgie maxillo-faciale Vuillemin SA, Fribourg, Switzerland;2. Department of Oral and Maxillofacial Surgery, John Radcliffe Hospital, Oxford, United Kingdom |
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| Abstract: | In patients treated by orbital wall decompression for endocrine orbitopathy (EO) there is limited evidence on the effect of orbital wall resections. Thus, the aim of this study was to evaluate the effect of one, two, and three-wall resections on orbital parameters to determine if any such correlations exist. Preoperative and postoperative data from all patients at a tertiary care centre who underwent decompression surgery from 2010 - 2020 were digitally analysed. The effect of the number and area of resected walls on orbital area, orbital volume, and Hertel value, and the effect of lateral rim advancement (LARA) were determined. A total of 131 orbital areas showed an increase from a mean (SD) preoperative area of 42.0 (4.6) cm2 to 47.3 (6.1) cm2 postoperatively (p<0.001). In total, the mean (SD) area of osseous wall removed in all patients was 6.2 (1.7) cm2 at the lateral orbit (n = 129), 6.7 (2.3) cm2 at the orbital floor (n = 123), and 5.8 (1.8) cm2 at the medial orbital wall (n =30). The mean (SD) orbital volume increased by 6.0 (3.0) cm3 after decompression. There was also a significant reduction in exophthalmos of 7.3 (3.2) mm (from 25.2 (3.9) to 17.9 (3.5), p<0.001). LARA was performed in 50 patients. Changes in volume and area, and reduction in exophthalmos were not significantly different with or without LARA. The postoperative effects of orbital wall resection are predictable and exhibit a relation with six units of change. Two-wall resection is the most common intervention. |
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| Keywords: | Endocrine orbitopathy Decompression surgery Navigated surgery Fully digital analysis |
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