J Neurol Surg B Skull Base 2020; 81(03): 244-250
DOI: 10.1055/s-0039-1688773
Original Article
Georg Thieme Verlag KG Stuttgart · New York

An Assessment of Globe Position Dynamics following Transcranial Lateral and Superior Orbital Wall Resections without Rigid Reconstruction: A Case Series of 55 Patients

Randall G. Krug II
1  Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota, United States
,
Elizabeth A. Bradley
2  Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
,
Jamie J. Van Gompel
3  Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, United States
4  Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, United States
› Author Affiliations
Further Information

Publication History

18 November 2018

20 March 2019

Publication Date:
21 May 2019 (online)

Abstract

Background There is no consensus exists regarding which reconstructive approach, if any, should be used after performing transcranial lateral orbital wall resections. Rigid reconstruction is often done to prevent enophthalmos; however, it is not clear if this is a risk with extensive orbital wall resections for transcranial surgery.

Objective To assess globe position dynamics in patients that underwent transcranial lateral and superior orbital wall resections without rigid reconstruction to determine if enophthalmos is a significant risk.

Methods Preoperative (PO) and postoperative data were retrospectively collected from the electronic medical records of 55 adult patients undergoing lateral and superior orbital wall resections as part of a skull base approach. The globe positions were assessed radiologically at all available time points and used to track relative globe displacements over time.

Results An evaluation of PO variables identified a relationship between maximum lesion diameters and globe positions dynamics. The composition of globe position presentations in the population remained relatively stable over time, with only 1 out of 55 patients (1.81%) developing postoperative enophthalmos. An assessment of mean globe displacements revealed improvements in the patients presenting with PO exophthalmos, and stability in the patients presenting with normal PO globe positions.

Conclusions Excellent results in long-term postoperative globe position dynamics can be achieved without the use of rigid reconstruction after transcranial lateral and superior orbital wall resections, regardless of the PO globe positioning.

Supplementary Material