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International Ophthalmology

, Volume 38, Issue 6, pp 2471–2475 | Cite as

Orbital fat volume in the inferolateral quadrant in Japanese: a guide for orbital fat decompression without injury to the oculomotor nerve

  • Yasuhiro TakahashiEmail author
  • Yoshiyuki Kitaguchi
  • Maria Suzanne Sabundayo
  • Hirohiko Kakizaki
Original Paper

Abstract

Purpose

The inferior oblique muscle branch of the oculomotor nerve is susceptible to injury during orbital fat removal from the inferolateral quadrant of the orbit. Understanding the amount of removable orbital fat volume in this quadrant may be helpful in achieving maximum fat decompression without causing nerve injury. The aim of this study was to calculate the orbital fat volume in the inferolateral quadrant using computed tomographic (CT) images.

Methods

In this retrospective, observational study, contiguous 1-mm coronal CT images were obtained from 53 sides (30 patients). The cross-sectional areas of the orbital fat in the inferolateral quadrant were measured from the level just behind the inferior oblique muscle to the orbital apex. The cross-sectional areas reached the inferior oblique muscle branch medially, the lateral orbital wall laterally, the inferior edge of the lateral rectus muscle superiorly, and the orbital floor inferiorly. An integrated value between the cross-sectional areas and the CT slice thickness was calculated.

Results

The mean orbital fat volume in the inferolateral quadrant was 3.9 ± 1.4 mL (range: 1.3–7.0 mL). Multiple regression analysis demonstrated a significant relationship between orbital fat volume and Hertel exophthalmometry measurement (adjusted r 2 = 0.101; P = 0.012), although the thickness of the lateral and inferior recti muscles was deleted from the regression equation by stepwise process.

Conclusions

The orbital fat volume in the inferolateral quadrant can serve as a guide for orbital fat removal without causing injury to the inferior oblique muscle nerve branch.

Keywords

Orbital fat Volume Inferolateral quadrant Decompression Inferior oblique muscle nerve branch Oculomotor nerve 

Notes

Compliance with ethical standards

Conflict of interest

The authors have no conflicting interests related to this manuscript.

References

  1. 1.
    Richter DF, Stoff A, Olivari N (2007) Transpalpebral decompression of endocrine ophthalmopathy by intraorbital fat removal (Olivari technique): experience and progression after more than 3000 operations over 20 years. Plast Reconstr Surg 120:109–123CrossRefGoogle Scholar
  2. 2.
    Lee KH, Jang SY, Lee SY, Yoon JS (2014) Graded decompression of orbital fat and wall in patients with Graves’ orbitopathy. Korean J Ophthalmol 28:1–11CrossRefGoogle Scholar
  3. 3.
    Tsutsumi S, Nakamura M, Tabuchi T, Yasumoto Y, Ito M (2013) An anatomic study of the inferior oblique nerve with high-resolution magnetic resonance imaging. Surg Radiol Anat 35:377–383CrossRefGoogle Scholar
  4. 4.
    Takahashi Y, Kakizaki H (2014) Horizontal eye position in thyroid eye disease: a retrospective comparison with normal individuals and changes after orbital decompression surgery. PLoS ONE 9:e114220CrossRefGoogle Scholar
  5. 5.
    Douglas RS, McCoy A, Gupta S (eds) (2015) Thyroid eye disease. Springer, New York, pp 13–114Google Scholar
  6. 6.
    Trokel S, Kazim M, Moor S (1993) Orbital fat removal: decompression for Graves orbitopathy. Ophthalmology 100:674–682CrossRefGoogle Scholar
  7. 7.
    O’Malley MR, Meyer DR (2009) Transconjunctival fat removal combined with conservative medial wall/floor orbital decompression for Graves orbitopathy. Ophthal Plast Reconstr Surg 25:206–210CrossRefGoogle Scholar
  8. 8.
    Takahashi Y, Nakano T, Miyazaki H, Kakizaki H (2016) An anatomical study of the orbital floor in relation to the infraorbital groove: implications of predisposition to orbital floor fracture site. Graefes Arch Clin Exp Ophthalmol 254:2049–2055CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  1. 1.Department of Oculoplastic, Orbital and Lacrimal SurgeryAichi Medical University HospitalNagakuteJapan

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