Orbital Expansion in Cranial Vault After Minimally Invasive Extradural Transorbital Decompression for Thyroid...

Area of Science:

• Neurosurgery
• Ophthalmology
• Radiology

Background:

• Thyroid eye disease often causes proptosis, necessitating surgical intervention.
• Minimally invasive extradural transorbital decompression is a surgical technique used to address proptosis.

Purpose of the Study:

• To investigate whether the orbit expands into the cranial vault after extradural transorbital decompression for thyroid eye disease.

Main Methods:

• A cohort study analyzed orbital CT scans of 36 patients (60 orbits) before and 6 months after surgery.
• The primary outcome was the change in the cranial vault's occupied area by orbital and brain tissue.

Main Results:

• Orbital tissue significantly expanded into the cranial vault post-surgery (70% vs. 0%, p < 0.001), with posterior brain displacement observed in 59 orbits.
• Mean proptosis reduction was 11.2 mm (p < 0.001). Diplopia and clinical activity scores showed non-significant changes.
• A low complication rate was reported, with 3% experiencing dural tears managed successfully.

Conclusions:

• Extradural transorbital decompression leads to orbital expansion within the cranial vault.
• The procedure is effective for proptosis reduction with a favorable safety profile.