New Method of Calculating the Excess Amount of Soft Tissues of the Orbit in Patients with Endocrine Ophthalmopathy when Planning Operations
https://doi.org/10.18008/1816-5095-2019-4-442-448
Abstract
Objective. Improving the efficiency of the operation of orbit decompression in patients with endocrine ophthalmopathy through the development of a new method for calculating an excess volume of soft tissues of the orbit.
Patients and methods. A total of 16 patients with edematous exophthalmos were examined, 7 of them were men and 9 women were aged 28 to 62 years (mean age 39 ± 8 years). All patients underwent surgery — simultaneous internal decompression of the orbit for bilateral exophthalmos with endocrine ophthalmopathy (EO). Before surgery and after 6 months. after surgery, patients were performed MSCT control. According to the method developed by us with the help of standard software MSCT, before the operation, calculations were made and the magnitude of the postoperative standing of the eyeballs was planned.
Results. As a result of the operations performed, we removed the estimated amount of adipose tissue and achieved the predicted result. Error in the calculations amounted to 0,1(+/-0,1) mm, which may be due to inaccurate labeling during planning.
Findings. The developed calculation method makes it possible to calculate the planned volume of the removed fatty tissue before the operation with the minimum error, without using complex mathematical calculations and without resorting to the help of additional equipment and software.
About the Authors
D. V. DavydovRussian Federation
MD, professor, head of Department of Reconstructive and Plastic Surgery with an Ophthalmology Course
Miklukho‑Maklaja str., 8, Moscow, 117198, Russian Federation
D. A. Lezhnev
Russian Federation
MD, Professor, head of Department of Radiology
Delegatskaja street, 20/1, Moscow, 127473, Russian Federation
K. A. Konovalov
Russian Federation
head of the ophthalmological Department
Mashtakova str. 4, Podolsk, Moscow region, 142110, Russian Federation
E. I. Belikova
Russian Federation
МD, рrofessor, head of the department of ophthalmology, Medical Director
Volokolamskoe Highway 91, Moscow, 125371, Russian Federation
26/2, Budenny Avenue, Moscow, 105118, Russia
M. D. Pozharitsky
Russian Federation
MD, professor, Head of anesthesiology department
Volokolamskoe Highway 91, Moscow, 125371, Russian Federation
References
1. McCord C. Orbital decompression for Graves’ disease: exposure through lateral canthal and inferior fornix incision. Ophthalmology. 1981;88:533–541.
2. Johnson М.Н. Anterior orbitotomy. Ophthalmic Surg. 1979;10(11):69–73.
3. Kochetkov P.A., Savvateeva D.M., Lopatin A.S. Orbit decompression: a review of surgical capabilities and analysis of their effectiveness. Russian Rhinology = Rossijskaja rinologija. 2013;21(1):28–34 (In Russ.)
4. Brovkina A.F. Modern aspects of the pathogenesis and treatment of endocrine ophthalmopathy. Annals of Russian academy of sciences = Vestnik Rossiyskoy akademii nauk. 2003;5:52–54 (In Russ.)
5. Kazim M., Trokel S.L., Acaroglu G., Elliott A. Reversal of dysthyroid optic neuropathy following orbital fat decompression. Br J Ophthalmol. 2000 Jun;84(6):600–605. DOI: 10.1136/bjo.84.6.600
6. Al‑Sharif E., Alsuhaibani A.H. Fat‑removal orbital decompression for thyroid associated orbitopathy: The right procedure for the right patient. Saudi J Ophthalmol. 2017 Jul‑Sep;31(3):156–161. DOI: 10.1016/j.sjopt.2017.05.017
7. De Bellis A., Perrino S., Coronella C. Extraocular muscle antibodies and the occurrence of ophthalmopathy in Graves disease. Clin. Endocrinol. 2004;60:694–698.
8. Wenz R., Levme M.R., Putterman A., Bersani T., Feldman К. Extraocular muscle enlargement after orbital decompression for Graves’ ophthalmopathy. Ophthal. Plast. Reconstr. Surg. 1994;10(1):34–41 DOI: 10.1016/j.compmedimag.2006.09.010
9. Jun Soo Byun, Nam Ju Moon, Jeong Kyu Lee. Quantitative analysis of orbital soft tissues on computed tomography to assess the activity of thyroid‑associated orbitopathy. Graefes Arch Clin Exp Ophthalmol, February 2017;255(2):413–420.
10. Jiang W., Cai Q.Y., Li Z.F., Chen Z.Y., Luo Y.S., Hu S.D., Shen J. Calculation of orbital fat volumes for determining treatment timing for thyroid‑ associated ophthalmopathy. Nan Fang Yi Ke Da Xue Xue Bao. 2017 May 20;37(5):640–645.
11. Brovkina A.F., Yatsenko O.Yu., Aubakirova S.A. Method of calculating the volume of orbital tissue removed during decompressive surgery in patients with endocrine ophthalmopathy Annals of Ophthalmology = Vestnik oftal’mologii 2009;3:24–27 (In Russ.)
12. Comerci M., Elefante A., Strianese D., Senese R., Bonavolonta P., Alfano B., Bonavolontà B., Brunetti A. Semiautomatic Regional Segmentation to Measure Orbital Fat Volumes in Thyroid‑Associated Ophthalmopathy: A Validation Study. The neuroradiology journal. 2013;26:373–379. DOI: 10.1177/197140091302600402
13. Yatsenko O.Yu. Volumetric‑topographic and structural changes in the soft tissues of the apex of the orbit during optical neuropathy in patients with edematous exophthalmos. Ophthalmology in Russia = Oftal’mologiya. 2014;11(2):48–54 (In Russ.). DOI: 10.18008/1816‑5095‑2014‑4
14. Cai Q.Y., Chen Z.Y., Jiang W., Luo Y.S., Li Z.F., Hu S.D., Shen J. A novel method for quantitative measurement of orbital fat volume based on magnetic resonance images. Nan Fang Yi Ke Da Xue Xue Bao. 2017 Sep 20;37(9):1248–1251.
15. Shen J., Jiang W., Luo Y., Cai Q., Li Z., Chen Z., Hu S., Tang L. Establishment of MRI 3D Reconstruction Technology of Orbital Soft Tissue and Its Preliminary Application in Patients with Thyroid‑Associated Ophthalmopathy. Clinical Endocrinology. 2018;88(5):637–644. DOI: 88. 10.1111/cen.13564
Review
For citations:
Davydov D.V., Lezhnev D.A., Konovalov K.A., Belikova E.I., Pozharitsky M.D. New Method of Calculating the Excess Amount of Soft Tissues of the Orbit in Patients with Endocrine Ophthalmopathy when Planning Operations. Ophthalmology in Russia. 2019;16(4):442-448. (In Russ.) https://doi.org/10.18008/1816-5095-2019-4-442-448