CT definition of the surgical apex in the orbit

Abstract The orbital apex is an undefined but well understood concept of Orbital Surgeons. We sought to determine the surgical apex area specifically where the volume ratio decreases significantly impacting on the optic nerve. A retrospective analysis using PACS program processing, measured the righ...

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Autores principales:	Olga Zurinam, Christine Safieh, Yael Redler, Adi Orbach, Dmitry Lumelsky, Ziv Neeman, Daniel Briscoe
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6f9e1771919046cdbf62299343860e77
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spelling	oai:doaj.org-article:6f9e1771919046cdbf62299343860e772021-12-02T15:49:31ZCT definition of the surgical apex in the orbit10.1038/s41598-021-90419-92045-2322https://doaj.org/article/6f9e1771919046cdbf62299343860e772021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90419-9https://doaj.org/toc/2045-2322Abstract The orbital apex is an undefined but well understood concept of Orbital Surgeons. We sought to determine the surgical apex area specifically where the volume ratio decreases significantly impacting on the optic nerve. A retrospective analysis using PACS program processing, measured the right retrobulbar space volume changes in 100 randomly selected cases without orbital pathology where CT was performed for non-ophthalmic indications. Volume of the retrobulbar space was measured between two recognizable landmarks. The first landmark being the point of exit of the optic nerve from the eye and the second landmark the optic nerve's point of exit from the orbit. The measured length between these two points was divided into five equal segments, V1-V5. The volumes of all 5 segments were compared and the most significant area of volume depletion was established. The mean numeric value of measured orbital volumes was compared. A ratio difference of V1/V2 was less than 2, V2/V3 was 2.32 (± 0.27), V3/4 was 3.24 (± 0.39), and V4/V5 was 5.67 (± 1.66). The most remarkable difference in ratio was between V4 and V5 (mean 5.67 ± 1.66 with p < .0001). The V3 segment (the posterior 3/5 of the retrobulbar space volume) is the location where decrease in orbital volume impacts, and measured ratios are statistically significant. We defined the surgical apex as the posterior 3/5 of the retro-bulbar orbital space. It is consequently the area of higher risk for optic nerve compression. This definition could be routinely utilized by ophthalmologists and neuroradiologists when evaluating masses affecting the orbit.Olga ZurinamChristine SafiehYael RedlerAdi OrbachDmitry LumelskyZiv NeemanDaniel BriscoeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Olga Zurinam Christine Safieh Yael Redler Adi Orbach Dmitry Lumelsky Ziv Neeman Daniel Briscoe CT definition of the surgical apex in the orbit
description	Abstract The orbital apex is an undefined but well understood concept of Orbital Surgeons. We sought to determine the surgical apex area specifically where the volume ratio decreases significantly impacting on the optic nerve. A retrospective analysis using PACS program processing, measured the right retrobulbar space volume changes in 100 randomly selected cases without orbital pathology where CT was performed for non-ophthalmic indications. Volume of the retrobulbar space was measured between two recognizable landmarks. The first landmark being the point of exit of the optic nerve from the eye and the second landmark the optic nerve's point of exit from the orbit. The measured length between these two points was divided into five equal segments, V1-V5. The volumes of all 5 segments were compared and the most significant area of volume depletion was established. The mean numeric value of measured orbital volumes was compared. A ratio difference of V1/V2 was less than 2, V2/V3 was 2.32 (± 0.27), V3/4 was 3.24 (± 0.39), and V4/V5 was 5.67 (± 1.66). The most remarkable difference in ratio was between V4 and V5 (mean 5.67 ± 1.66 with p < .0001). The V3 segment (the posterior 3/5 of the retrobulbar space volume) is the location where decrease in orbital volume impacts, and measured ratios are statistically significant. We defined the surgical apex as the posterior 3/5 of the retro-bulbar orbital space. It is consequently the area of higher risk for optic nerve compression. This definition could be routinely utilized by ophthalmologists and neuroradiologists when evaluating masses affecting the orbit.
format	article
author	Olga Zurinam Christine Safieh Yael Redler Adi Orbach Dmitry Lumelsky Ziv Neeman Daniel Briscoe
author_facet	Olga Zurinam Christine Safieh Yael Redler Adi Orbach Dmitry Lumelsky Ziv Neeman Daniel Briscoe
author_sort	Olga Zurinam
title	CT definition of the surgical apex in the orbit
title_short	CT definition of the surgical apex in the orbit
title_full	CT definition of the surgical apex in the orbit
title_fullStr	CT definition of the surgical apex in the orbit
title_full_unstemmed	CT definition of the surgical apex in the orbit
title_sort	ct definition of the surgical apex in the orbit
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/6f9e1771919046cdbf62299343860e77
work_keys_str_mv	AT olgazurinam ctdefinitionofthesurgicalapexintheorbit AT christinesafieh ctdefinitionofthesurgicalapexintheorbit AT yaelredler ctdefinitionofthesurgicalapexintheorbit AT adiorbach ctdefinitionofthesurgicalapexintheorbit AT dmitrylumelsky ctdefinitionofthesurgicalapexintheorbit AT zivneeman ctdefinitionofthesurgicalapexintheorbit AT danielbriscoe ctdefinitionofthesurgicalapexintheorbit
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CT definition of the surgical apex in the orbit

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