Consideration of specific key points improves outcome of decompression treatment in patients with endocrine orbitopathy: pre-/post-OP comparison and biomechanical simulation
Abstract 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 care...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-022-00709-9 |
| _version_ | 1811241208335302656 |
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| author | Matthias Krause Michael-Tobias Neuhaus Ina Sterker Alexander K. Bartella Annika Schönfeld Bernd Lethaus Rüdiger Zimmerer Evgeny Gladilin |
| author_facet | Matthias Krause Michael-Tobias Neuhaus Ina Sterker Alexander K. Bartella Annika Schönfeld Bernd Lethaus Rüdiger Zimmerer Evgeny Gladilin |
| author_sort | Matthias Krause |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-12T13:33:07Z |
| format | Article |
| id | doaj.art-a826c465e1df4f8e8746300d82ba5c8e |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-04-12T13:33:07Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-a826c465e1df4f8e8746300d82ba5c8e2022-12-22T03:31:07ZengBMCEuropean Journal of Medical Research2047-783X2022-06-012711810.1186/s40001-022-00709-9Consideration of specific key points improves outcome of decompression treatment in patients with endocrine orbitopathy: pre-/post-OP comparison and biomechanical simulationMatthias Krause0Michael-Tobias Neuhaus1Ina Sterker2Alexander K. Bartella3Annika Schönfeld4Bernd Lethaus5Rüdiger Zimmerer6Evgeny Gladilin7Department of Oral and Maxillofacial Surgery, Leipzig UniversityDepartment of Oral and Maxillofacial Surgery, Leipzig UniversityDepartment of Ophthalmology, Leipzig UniversityDepartment of Oral and Maxillofacial Surgery, Leipzig UniversityDepartment of Oral and Maxillofacial Surgery, Leipzig UniversityDepartment of Oral and Maxillofacial Surgery, Leipzig UniversityDepartment of Oral and Maxillofacial Surgery, Leipzig UniversityApplied Bioinformatics, German Cancer Research CenterAbstract 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.https://doi.org/10.1186/s40001-022-00709-9Endocrine orbitopathyDecompression surgeryComputer tomography dataBiomechanical simulation |
| spellingShingle | Matthias Krause Michael-Tobias Neuhaus Ina Sterker Alexander K. Bartella Annika Schönfeld Bernd Lethaus Rüdiger Zimmerer Evgeny Gladilin Consideration of specific key points improves outcome of decompression treatment in patients with endocrine orbitopathy: pre-/post-OP comparison and biomechanical simulation European Journal of Medical Research Endocrine orbitopathy Decompression surgery Computer tomography data Biomechanical simulation |
| title | Consideration of specific key points improves outcome of decompression treatment in patients with endocrine orbitopathy: pre-/post-OP comparison and biomechanical simulation |
| title_full | Consideration of specific key points improves outcome of decompression treatment in patients with endocrine orbitopathy: pre-/post-OP comparison and biomechanical simulation |
| title_fullStr | Consideration of specific key points improves outcome of decompression treatment in patients with endocrine orbitopathy: pre-/post-OP comparison and biomechanical simulation |
| title_full_unstemmed | Consideration of specific key points improves outcome of decompression treatment in patients with endocrine orbitopathy: pre-/post-OP comparison and biomechanical simulation |
| title_short | Consideration of specific key points improves outcome of decompression treatment in patients with endocrine orbitopathy: pre-/post-OP comparison and biomechanical simulation |
| title_sort | consideration of specific key points improves outcome of decompression treatment in patients with endocrine orbitopathy pre post op comparison and biomechanical simulation |
| topic | Endocrine orbitopathy Decompression surgery Computer tomography data Biomechanical simulation |
| url | https://doi.org/10.1186/s40001-022-00709-9 |
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