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Comparison of degree of medial rectus muscle misalignment after medial orbital wall decompression with or without periosteal flap

  • Oculoplastics and Orbit
  • Published:
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Abstract

Purpose

To compare the degree of postoperative medial rectus (MR) muscle misalignment in patients who underwent medial orbital wall decompression with or without a periosteal flap along the MR muscle.

Methods

This retrospective, observational study included 40 sides from 26 patients. The following parameters were measured on axial computed tomographic images taken post- and/or preoperatively: the distance of the anteroposterior line between the posterior lacrimal crest and the junction of the ethmoid and sphenoid sinuses from the most medial point of the medial margin of the MR muscle; the angle created at the point of the MR globe insertion, the most medial point of the MR muscle, and the junction of the ethmoid and sphenoid sinuses; and the MR muscle cross-sectional area. Postoperative changes in the distance (MR muscle shift) and area (MR muscle expansion) were calculated, and MR muscle shift, MR muscle angle, and the rate of MR muscle expansion were compared between the groups with (22 sides) and without (18 sides) a periosteal flap.

Results

MR muscle shift (P = 0.325), MR muscle angle (P = 0.219), and the rate of MR muscle expansion (P = 0.904) were not significantly different between the groups.

Conclusions

Preservation of the periosteum along the MR muscle is thought to prevent MR muscle misalignment after medial orbital wall decompression. However, the results of this study indicate that preservation of a periosteal flap may not contribute to lessening MR muscle shift after surgery.

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Data availability

All data are included in this paper.

Code availability

N/A.

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Author information

Authors and Affiliations

  1. Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, 1-1 Yazako-Karimata, Nagakute, Aichi, 480-1195, Japan

    Yasuhiro Takahashi, Aric Vaidya & Hirohiko Kakizaki

  2. Department of Oculoplastic, Orbital & Lacrimal Surgery, Rapti Eye Hospital, Dang, Nepal

    Aric Vaidya

  3. Department of Otorhinolaryngology, Aichi Medical University, Aichi, Japan

    Kinga Yo & Yuka Kawade

Authors
  1. Yasuhiro Takahashi
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  2. Aric Vaidya
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  3. Kinga Yo
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  4. Yuka Kawade
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  5. Hirohiko Kakizaki
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Contributions

QueryAll the authors qualify for authorship based on contributions to the conception and design (YT), acquisition of data (YT), literature search (YT), and analyses and interpretation of data (all authors). All the authors contributed to drafting the article and revising it critically for important intellectual content and final approval of the version to be published.

Other contributors

No one contributed to the work who did not meet our authorship criteria.

Corresponding author

Correspondence to Yasuhiro Takahashi.

Ethics declarations

Ethics approval

This study was approved by the Institutional Review Board (IRB) of Aichi Medical University Hospital (approval No, 2019–034) and followed the tenets of the 1964 Declaration of Helsinki.

Consent to participate

The IRB granted a waiver of informed consent for this study based on the ethical guidelines for medical and health research involving human subjects established by the Japanese Ministry of Education, Culture, Sports, Science, and Technology and the Ministry of Health, Labour, and Welfare. The waiver was granted because the study was a retrospective chart review, not an interventional study, and because it was difficult to obtain consent from patients who had been treated several years prior to the study. Nevertheless, at the request of the IRB, we published an outline of the study, which is available for public viewing on the Aichi Medical University Hospital website. This public posting also allowed patients the opportunity to decline participation, although none of the patients did so. Personal identifiers were removed from all records before data analysis.

Consent for publication

All the authors agreed with publication of this paper.

Competing interests

The authors declare no competing interests.

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Takahashi, Y., Vaidya, A., Yo, K. et al. Comparison of degree of medial rectus muscle misalignment after medial orbital wall decompression with or without periosteal flap. Graefes Arch Clin Exp Ophthalmol 260, 1025–1031 (2022). https://doi.org/10.1007/s00417-021-05413-8

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  • DOI: https://doi.org/10.1007/s00417-021-05413-8

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