Otolaryngologist surgical preferences for orbital decompression in thyroid eye disease: A <scp>North American</scp> survey
Bibliographic record
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.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.003 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".