Our experience in the use of modern computer technology with the manufacture of navigation templates for surgical decompression of the orbit in patients with endocrine orbitopathy

Abstract

AbstractPurposeOptimization of bone orbit decompression in patients with endocrine orbitopathy using Computer‐Aided Design (CAD) / Computer‐Aided Manufacturing (CAM) technologies with the manufacture of navigation templates.MethodsTo achieve this goal, the results of bone decompression of the orbit in 12 patients were analyzed. Each patient underwent a standard ophthalmological examination and assessment of binocular vision. Before and after surgery, patients underwent multislice computed tomography, the size of the exophthalmos was performed by the method of Ramli et al., 2015. With the help of CAD / CAM technologies, resection surgical templates were made for bone decompression of the orbit.ResultsThe study included 12 patients (24 orbits) – 7 (58.3%) women and 5 (41.7%) men. All patients underwent combined bilateral orbital decompression. The average value of exophthalmos before surgery was 24.6 ± 3.5 mm on the left and 23.6 ± 2.9 mm on the right, and after surgery 21.4 ± 2.8 mm and 21.1 ± 2.9 mm, respectively, indicating a significant improvement in eye position (p > 0.05).In 2 patients (16.6%) diplopia was observed, in one patient (8.3%) ‐ hypoesthesia of the second branch of the trigeminal nerve in the early postoperative period. Late postoperative complications (follow‐up 3 months) were not observed.ConclusionsSurgical decompression of the orbit using navigation templates can significantly reduce the degree of exophthalmos by an average of 3.2 mm, while reducing the area of bone resection, which reduces the risk of postoperative complications due to damage to the oculomotor muscles and the hyoid nerve. An individualized approach using CAD/CAM technologies is necessary to achieve optimal treatment results in patients with endocrine orbitopathy.