Purpose

To compare outcome and complications of endoscopic orbital decompression performed with and without CT-guided navigation in patients with thyroid eye disease (TED).

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Methods

This retrospective study included TED patients who underwent endoscopic orbital decompression at Haukeland University Hospital between 1999 and 2023. Data were collected from hospital records, follow-up examinations, and pre- and postoperative CT imaging.

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Results

A total of 64 patients (56 women) were included, with a median (range) age of 54.5 (23-84) years at surgery and a median follow-up time of 48 (1–158) months. Of these, 28 patients underwent navigation-assisted surgery and 35 underwent conventional surgery. Improvement in mean (SD) visual acuity was significantly better in the navigation group (0.21 (0.23)) compared to the non-navigation group (0.10 (0.21)), p=0.02. Improvement in exophthalmos was significantly less with navigation (2.79 mm) compared to without (4.04 mm), p=0.042

Postoperatively, strabismus surgery was performed in 18 (64.3%) patients in the navigation group and 31 (88.5%) patients in the non navigation group. Persistent diplopia after strabismus surgery occurred in 37.8% and 35.5% of patients, respectively. Pre- and postoperative CT segmentation was used to measure orbital volume increase after surgery.

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Conclusion

Navigation-assisted endoscopic medial orbital decompression appears to enable more targeted decompression, resulting in less exophthalmos reduction but improved visual outcomes and a reduced need for subsequent strabismus surgery.

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Additional Authors

First name	Last name	Base Hospital / Institution
Shashi	Gulati	Haukeland University Hospital
Hauke	Bartsch	Mohn Medical Imaging and Visualization Centre
Tormund	Njølstad	Haukeland University Hospital
Olav	Haugen	Haukeland University Hospital
Eyvind	Rødahl	University of Bergen
Hans Olav	Ueland	Haukeland University Hospital

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