Volumetric Analysis of Navigation-Guided Orbital Decompression in Graves' Orbitopathy: A Case Report

Graves' orbitopathy (GO) is a debilitating autoimmune disorder that may require surgical orbital decompression in severe cases with risk of proptosis and optic neuropathy. This report presents a case treated with navigation-assisted three-wall orbital decompression, planned with preoperative imaging and assessed using postoperative analysis. Intraoperative navigation enabled precise localization of critical structures, improving osteotomy execution. Postoperatively, orbital volume increased by 3.5 cm³ (right eye) and 4.0 cm³ (left eye), while proptosis was reduced by 6 mm in both eyes. These changes correlated with intraocular pressure normalization and functional improvement. This was further supported by a postoperative Clinical Activity Score (CAS) of 0, indicating active orbital inflammation. Image-guided surgery (IGS) achieved an average proptosis reduction of 3.8 mm, slightly superior to that of non-guided techniques. Although IGS enhances precision and functional outcomes, it requires longer surgical time and incurs higher costs, highlighting the need for prospective studies on long-term efficacy This case supports the importance of integrating advanced imaging and navigation-assisted techniques in GO management to improve both functional and aesthetic outcomes.