Otolaryngologist surgical preferences for orbital decompression in thyroid eye disease: A North American survey
Abstract Background Orbital decompression is recommended for TED especially in the treatment of severe, refractory cases yet there are no clear guidelines regarding the optimal surgical approach. Previously conducted surveys assessed variations in the management of TED but only amongst ophthalmologi...
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Wiley
2024-12-01
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| Series: | Laryngoscope Investigative Otolaryngology |
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| Online Access: | https://doi.org/10.1002/lio2.70051 |
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| author | Ryan C. Higgins Ciaran F. Lane Neerav Goyal |
| author_facet | Ryan C. Higgins Ciaran F. Lane Neerav Goyal |
| author_sort | Ryan C. Higgins |
| collection | DOAJ |
| description | Abstract Background Orbital decompression is recommended for TED especially in the treatment of severe, refractory cases yet there are no clear guidelines regarding the optimal surgical approach. Previously conducted surveys assessed variations in the management of TED but only amongst ophthalmologists. Our study attempts to better characterize surgical and perioperative preferences amongst otolaryngologists in the management of TED. Methods A survey was administered to the American Rhinologic Society and Canadian Society of Otolaryngology – Head and Neck Surgery via REDCap with 52 total respondents. Respondent demographic information and pre‐operative management, procedural specifics, and post‐operative management preferences were collected. Results The majority of respondents practiced in a metropolitan (82.7%), academic setting (73.1%) and received subspecialty training in Rhinology & Skull Base Surgery (88.9%). Most elected for corticosteroids (63.5%) and medical management (69.2%) prior to orbital decompression but did not use any classification system (86.5%). Orbital decompression was most often done with ophthalmology collaboration (71.2%). Removal of two bony walls (55.8%) via medial wall (97.9%) and orbital floor (72.3%) removal was most preferred. Removal of one orbital fat aspect (60.6%) via the medial fat pad was most preferred. Combined bone and fat removal (59.6%) completed via an endoscopic approach (71.2% and 97.0%, respectively) was most common. Post‐operatively, most patients were not admitted (88.4%) with saline nasal rinses (92.3%) utilized by most respondents. Conclusions This survey completed by otolaryngologists highlights several key distinctions in the preferred surgical approach during orbital decompression and the perioperative management of TED when compared to ophthalmologists and current recommendations. Level of evidence Level 4. |
| format | Article |
| id | doaj-art-81e8ea55ca0c4dc1b815097e7a110925 |
| institution | DOAJ |
| issn | 2378-8038 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj-art-81e8ea55ca0c4dc1b815097e7a1109252025-08-20T02:39:59ZengWileyLaryngoscope Investigative Otolaryngology2378-80382024-12-0196n/an/a10.1002/lio2.70051Otolaryngologist surgical preferences for orbital decompression in thyroid eye disease: A North American surveyRyan C. Higgins0Ciaran F. Lane1Neerav Goyal2Department of Otolaryngology University of Nebraska Medical Center Omaha Nebraska USADepartment of Otolaryngology University of Manitoba Winnipeg Manitoba CanadaDepartment of Otolaryngology The Pennsylvania State University, College of Medicine Hershey Pennsylvania USAAbstract Background Orbital decompression is recommended for TED especially in the treatment of severe, refractory cases yet there are no clear guidelines regarding the optimal surgical approach. Previously conducted surveys assessed variations in the management of TED but only amongst ophthalmologists. Our study attempts to better characterize surgical and perioperative preferences amongst otolaryngologists in the management of TED. Methods A survey was administered to the American Rhinologic Society and Canadian Society of Otolaryngology – Head and Neck Surgery via REDCap with 52 total respondents. Respondent demographic information and pre‐operative management, procedural specifics, and post‐operative management preferences were collected. Results The majority of respondents practiced in a metropolitan (82.7%), academic setting (73.1%) and received subspecialty training in Rhinology & Skull Base Surgery (88.9%). Most elected for corticosteroids (63.5%) and medical management (69.2%) prior to orbital decompression but did not use any classification system (86.5%). Orbital decompression was most often done with ophthalmology collaboration (71.2%). Removal of two bony walls (55.8%) via medial wall (97.9%) and orbital floor (72.3%) removal was most preferred. Removal of one orbital fat aspect (60.6%) via the medial fat pad was most preferred. Combined bone and fat removal (59.6%) completed via an endoscopic approach (71.2% and 97.0%, respectively) was most common. Post‐operatively, most patients were not admitted (88.4%) with saline nasal rinses (92.3%) utilized by most respondents. Conclusions This survey completed by otolaryngologists highlights several key distinctions in the preferred surgical approach during orbital decompression and the perioperative management of TED when compared to ophthalmologists and current recommendations. Level of evidence Level 4.https://doi.org/10.1002/lio2.70051endoscopyorbital decompressionotolaryngologythyroid eye disease |
| spellingShingle | Ryan C. Higgins Ciaran F. Lane Neerav Goyal Otolaryngologist surgical preferences for orbital decompression in thyroid eye disease: A North American survey Laryngoscope Investigative Otolaryngology endoscopy orbital decompression otolaryngology thyroid eye disease |
| title | Otolaryngologist surgical preferences for orbital decompression in thyroid eye disease: A North American survey |
| title_full | Otolaryngologist surgical preferences for orbital decompression in thyroid eye disease: A North American survey |
| title_fullStr | Otolaryngologist surgical preferences for orbital decompression in thyroid eye disease: A North American survey |
| title_full_unstemmed | Otolaryngologist surgical preferences for orbital decompression in thyroid eye disease: A North American survey |
| title_short | Otolaryngologist surgical preferences for orbital decompression in thyroid eye disease: A North American survey |
| title_sort | otolaryngologist surgical preferences for orbital decompression in thyroid eye disease a north american survey |
| topic | endoscopy orbital decompression otolaryngology thyroid eye disease |
| url | https://doi.org/10.1002/lio2.70051 |
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