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Impact of sphenoid trigone size and extraocular muscle thickness on the outcome of lateral wall orbital decompression for thyroid eye disease

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Abstract

Background

To retrospectively review lateral wall orbital decompression for thyroid eye disease (TED) and to evaluate pre-operative CT scans to analyse the variation in proptosis reduction.

Methods

Consecutive lateral wall orbital decompressions performed by a single surgeon were retrospectively reviewed. Pre-operative CT scan features and post-operative proptosis reduction were analysed. The sphenoid trigone cross-sectional areas were summed and multiplied by the slice thickness to yield bone volume. Cumulative extraocular muscle thickness was calculated by combining the maximum thickness of the four recti. “Trigone volume” and “cumulative muscle thickness” were correlated with proptosis reduction at 3 months post-surgery.

Results

Out of 73 consecutive lateral wall orbital decompressions, 17 orbits had prior endonasal medial wall orbital decompression. In the remaining 56 orbits, the mean pre-operative and post-operative proptosis were 24.3 ± 1.6 mm and 20.9 ± 2.3 mm respectively. The proptosis reduction ranged from 1 to 7 mm (mean of 3.5 mm ± 1.3 (p < 0.001)). Mean sphenoid trigone volume was 895 ± 434.4 mm3. The mean cumulative muscle thickness was 20.4 ± 5 mm. The correlation coefficient between muscle thickness and proptosis reduction was − 0.3 and was statistically significant (p = 0.043). The correlation coefficient between sphenoidal trigone volume and proptosis reduction was 0.2 (p = 0.068). With a multivariate analysis, the coefficient of efficient of regression for muscle thickness was − 0.007 (p = 0.42) and the coefficient of regression for trigone volume was 0.0 (p = 0.046).

Conclusion

Proptosis reduction following lateral wall orbital decompression can be variable. Extraocular muscle thickness had a significant correlation with the outcome, with greater proptosis reduction in orbits with thin muscles. The sphenoidal trigone size had a weak correlation with decompression outcome.

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Acknowledgements

We acknowledge Dr Dympna McAteer, Radiologist at Aberdeen Royal Infirmary, and Dr Oliver Cram, Radiologist at Gartnavel General Hospital, for their expert opinion on radiological assessment and Margaret Daddow for facilitating data acquisition.

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Authors and Affiliations

  1. Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Rd, Glasgow, G12 0YN, UK

    Manvi Sobti, Kerr Brogan, Radhika Patel, David Miller, Vikas Chadha & Paul Cauchi

Authors
  1. Manvi Sobti
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  2. Kerr Brogan
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  3. Radhika Patel
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  4. David Miller
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  5. Vikas Chadha
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  6. Paul Cauchi
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Contributions

All authors contributed to this study. Paul Cauchi and Manvi Sobti contributed to the study conception and design. Material preparation and data collection and analysis were performed by Manvi Sobti, Kerr Brogan and Radhika Patel. The first draft of the manuscript was written by Manvi Sobti and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Manvi Sobti.

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Ethics approval

This is an observational study. The West of Scotland Research Ethics Service has confirmed that no ethical approval is required.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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These results have been presented at the ESOPRS 2017 Meeting, Stockholm as an oral presentation and at BOPSS 2017 Meeting, London as a poster.

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Sobti, M., Brogan, K., Patel, R. et al. Impact of sphenoid trigone size and extraocular muscle thickness on the outcome of lateral wall orbital decompression for thyroid eye disease. Oral Maxillofac Surg 28, 307–313 (2024). https://doi.org/10.1007/s10006-023-01143-9

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  • DOI: https://doi.org/10.1007/s10006-023-01143-9

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