CC BY-NC-ND 4.0 · Laryngorhinootologie 2019; 98(S 02): S21
DOI: 10.1055/s-0039-1685675
Abstracts
Imaging/Sonography

How can the analysis of the orbital morphology in a CT scan help planning decompression surgery?

K Stähr
1   Uniklinikum Essen, Klinik für Hals-Nasen-Ohrenheilkunde, Essen
,
M Oeverhaus
2   Universitätsklinikum Essen, Klinik für Augenheilkunde, Essen
,
A Eckstein
2   Universitätsklinikum Essen, Klinik für Augenheilkunde, Essen
,
A Coppei
2   Universitätsklinikum Essen, Klinik für Augenheilkunde, Essen
,
A Schlüter
3   Universitätsklinikum Essen, Klinik für Hals-Nasen-Ohrenheilkunde, Essen
,
S Lang
3   Universitätsklinikum Essen, Klinik für Hals-Nasen-Ohrenheilkunde, Essen
,
S Mattheis
3   Universitätsklinikum Essen, Klinik für Hals-Nasen-Ohrenheilkunde, Essen
› Author Affiliations
 

Introduction:

Orbital decompression surgery is performed in patients with Graves' orbitopathy to treat dysthyroid optical neuropathy and reduce disfiguring proptosis. Using a graduated technique, the preoperative planning is essential for an optimal surgical result. We performed a retrospective study to identify anatomical factors in computed tomography (CT), which influence the surgical effect and postoperative ocular motility.

Methods:

Pre- and postoperative CT-scans of 125 orbits (68 patients) have been analyzed. Proptosis, ductions, misalignment and diplopia were assessed before and after surgery. Orbital wall length, conus angle, depth of ethmoidal sinus, orbital surface, length orbital defect, depth of tissue prolapse were analyzed in CT scans pre- and postoperatively. With linear regression and multivariate analyses these parameters have been correlated with postoperative proptosis, abduction deficit, deviation and binocular single vision (BSV).

Results:

Multiple linear regression showed a significant correlation between tissue prolapse and depth of the ethmoidal sinus. Proptosis reduction could not be predicted by tissue prolapse, defect length or depth of ethmoidal sinus. The abduction deficit correlated significantly with tissue prolapse and orbital surface area.

Conclusion:

We could show that orbital morphology influences the outcome of balanced orbital decompression surgery in terms of tissue prolaps and motility. According to our findings and intraoperative impressions, the reduction of proptosis is not only influenced by the bony morphology but also by the grade of intraorbital fibrosis and enlargement of the eye muscles.



Publication History

Publication Date:
23 April 2019 (online)

© 2019. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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