Consideration of specific key points improves outcome of decompression treatment in patients with endocrine orbitopathy: pre-/post-OP comparison and biomechanical simulation.

Biomechanical simulation Computer tomography data Decompression surgery Endocrine orbitopathy

Journal

European journal of medical research
ISSN: 2047-783X
Titre abrégé: Eur J Med Res
Pays: England
ID NLM: 9517857

Informations de publication

Date de publication:
13 Jun 2022
Historique:
received: 24 03 2022
accepted: 10 05 2022
entrez: 13 6 2022
pubmed: 14 6 2022
medline: 16 6 2022
Statut: epublish

Résumé

Endocrine orbitopathy is typically treated by resecting orbital walls. This procedure reduces intraorbital pressure by releasing intraorbital tissue, effectively alleviating the symptoms. However, selection of an appropriate surgical plan for treatment of endocrine orbitopathy requires careful consideration because predicting the effects of one-, two-, or three-wall resections on the release of orbital tissues is difficult. Here, based on our experience, we describe two specific orbital sites ('key points') that may significantly improve decompression results. Methodological framework of this work is mainly based on comparative analysis pre- and post-surgery tomographic images as well as image- and physics-based simulation of soft tissue outcome using the finite element modelling of mechanical soft tissue behaviour. Thereby, the optimal set of unknown modelling parameters was obtained iteratively from the minimum difference between model predictions and post-surgery ground truth data. This report presents a pre-/post-surgery study indicating a crucial role of these particular key points in improving the post-surgery outcome of decompression treatment of endocrine orbitopathy which was also supported by 3D biomechanical simulation of alternative two-wall resection plans. In particular, our experimental results show a nearly linear relationship between the resection area and amount of tissue released in the extraorbital space. However, a disproportionately higher volume of orbital outflow could be achieved under consideration of the two special key points. Our study demonstrates the importance of considering natural biomechanical obstacles to improved outcomes in two-wall resection treatment of endocrine orbitopathy. Further investigations of alternative surgery scenarios and post-surgery data are required to generalize the insights of this feasibility study.

Identifiants

pubmed: 35698208
doi: 10.1186/s40001-022-00709-9
pii: 10.1186/s40001-022-00709-9
pmc: PMC9195310
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

92

Informations de copyright

© 2022. The Author(s).

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Auteurs

Matthias Krause (M)

Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany. krausema@medizin.uni-leipzig.de.

Michael-Tobias Neuhaus (MT)

Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany.

Ina Sterker (I)

Department of Ophthalmology, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany.

Alexander K Bartella (AK)

Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany.

Annika Schönfeld (A)

Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany.

Bernd Lethaus (B)

Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany.

Rüdiger Zimmerer (R)

Department of Oral and Maxillofacial Surgery, Leipzig University, Liebigstraße 12, 04103, Leipzig, Germany.

Evgeny Gladilin (E)

Applied Bioinformatics, German Cancer Research Center, Berliner Str. 41, 69120, Heidelberg, Germany.
Leibniz Institute of Plant Genetics and Crop Plant Research, Corrensstrasse 3, OT Gatersleben, 06466, Seeland, Germany.

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