Comparação entre os resultados da descompressão orbitária antro-etmoidal isolada e associada à remoção de tecido adiposo

Gonçalves, Arthur Lopes; Moura, Frederico Castelo; Moura, Janete; Bloise, W; Monteiro, Mário Luiz Ribeiro

doi:10.1590/s0004-27492005000400006

Cited by 3 publications

(4 citation statements)

References 18 publications

(21 reference statements)

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“…IM-OD was performed with some modifications to the previous descriptions (10,11). Briefly, the transcaruncular approach was used to access the medial wall of the orbit (12).…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…The inferior limit (the junction with the maxillary bone comprising the inferomedial orbital strut) was preserved in the anterior portion. The orbital floor (maxillary sinus roof) was accessed through a fornix transconjunctival incision (10,11), without lateral canthotomy whenever possible. The maxillary fracture comprised only the medial portion relative to the infraorbital groove.…”

Section: Surgical Techniquesmentioning

confidence: 99%

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Ocular motility changes after inferomedial wall and balanced medial plus lateral wall orbital decompression in Graves' orbitopathy: a randomized prospective comparative study

Leite¹,

Pereira²,

Chiang³

et al. 2021

Clinics

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To compare the surgical outcomes of inferomedial wall orbital decompression (IM-OD) and balanced medial plus lateral wall orbital decompression (ML-OD) in patients with inactive Graves' orbitopathy (GO) with regard to exophthalmos reduction and ocular motility abnormalities. METHODS: Forty-two patients with inactive GO eligible for OD were randomly assigned to either the IM-OD or ML-OD groups. Pre and postoperative evaluations included Hertel exophthalmometry, sensory, and motor extraocular motility assessment, standardized photographs in the nine gaze positions, and computed tomography (CT) of the orbits. ClinicalTrials.gov: NCT03278964. RESULTS: Exophthalmometry reduction was statistically significant in both groups (po0.001), but was greater in the ML-OD group (p=0.010). New-onset esotropia occurred in 11.1% and 23.5% of patients who underwent IM-OD and ML-OD, respectively, with no statistically significant difference in the frequency of pre and postoperative strabismus in either group. The mean increase in preoperative esotropia was 24 ± 6.9 and 12 ± 8.8 prism diopters in patients who underwent IM-OD and ML-OD, respectively. In the IM-OD group, abduction and elevation worsened at the first (po0.05) and third (po0.05) postoperative visits but were restored at 6 months. The versions did not change postoperatively with ML-OD. The preoperative CT-measured medial rectus muscle area predicted new-onset strabismus (p=0.023). Significant postoperative medial rectus muscle enlargement occurred in both groups (po0.001). Restriction in elevation and abduction was significantly associated with enlarged inferior (p=0.007) and medial rectus muscle areas (p=0.002). CONCLUSIONS: IM-OD is as safe as ML-OD with regard to new-onset strabismus, and represents a good alternative for patients who do not require significant exophthalmos reduction. ML-OD offers greater exophthalmos reduction and smoother postoperative recovery. Patients with preoperative enlarged medial rectus muscle on CT are at risk for new-onset esotropia, and preoperative esotropia is likely to increase after OD.

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“…IM-OD was performed with some modifications to the previous descriptions (10,11). Briefly, the transcaruncular approach was used to access the medial wall of the orbit (12).…”

Section: Surgical Techniquesmentioning

confidence: 99%

Section: Surgical Techniquesmentioning

confidence: 99%

Ocular motility changes after inferomedial wall and balanced medial plus lateral wall orbital decompression in Graves' orbitopathy: a randomized prospective comparative study

Leite¹,

Pereira²,

Chiang³

et al. 2021

Clinics

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“…A neuropatia, a grave congestão orbitária e a úlcera corneana por exposição são as principais indicações cirúrgicas, no entanto, existem atualmente indicações mais amplas para essa cirurgia na fase ativa da OG, como a inflamação persistente, dor retrobulbar e a dependência ao uso do corticosteroide (13,27,72,73) . Na maioria dos casos, a descompressão ocorre na fase sequelar com fins reabilitativos funcionais e cosméticos (15,23) .…”

Section: Descompressão Orbitáriaunclassified

“…A parede medial, composta pela lâmina papirácea do osso etmoide, foi fraturada, respeitando seus limites superior com o osso frontal e posterior com a asa preservada (84,118) . A descompressão do assoalho orbitário foi restrita à porção medial do osso maxilar entre o esporão orbitário e o sulco infraorbitário, por meio uma incisão transconjuntival (23,89) , sem a realização de cantotomia lateral. Após as fraturas ósseas, foram realizadas incisões na periórbita, para herniação da gordura (Figura 10).…”

Section: Técnicas Cirúrgicasunclassified

Estudo comparativo dos resultados da descompressão orbitária inferomedial vs. balanceada em pacientes com Orbitopatia de Graves, por meio de análise tomográfica, fotográfica e clínica

Pereira¹

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Ao meu orientador, Professor Dr. Allan Christian Pieroni Gonçalves, pela excelente condução desta tese, com dedicação, paciência e disponibilidade para compartilhar todo seu conhecimento. Obrigada por acreditar em minha competência como pesquisadora e ter me escolhido como sua aluna da pósgraduação. Ao Professor Dr. Mário Luiz Ribeiro Monteiro, pelo exemplo de liderança, dedicação e incentivo constante à pesquisa científica no Departamento de Oftalmologia da FMUSP e neste projeto. À Secretária, Sra. Regina Ferreira de Almeida, pelo auxílio, atuação presente e dedicação constante ao serviço de pósgraduação da Disciplina de Oftalmologia da FMUSP.Às radiologistas Dra. Eloísa Maria Mello Santiago Gebrim e Dra. Cristina Hiromi Kuniyoshi pela colaboração na execução deste projeto.Aos pacientes, que possibilitaram a realização desta tese e contribuíram para a construção do conhecimento.A todos os Professores, colegas, residentes e funcionários do Departamento de Oftalmologia do HCFMUSP que contribuíram para a realização deste projeto de alguma forma.

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A randomized comparative study of inferomedial vs. balanced orbital decompression. Analysis of changes in orbital volume, eyelid parameters, and eyeball position

Pereira

Leite

Kuniyoshi

et al. 2021

Eye

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Comparação entre os resultados da descompressão orbitária antro-etmoidal isolada e associada à remoção de tecido adiposo

Cited by 3 publications

References 18 publications

Ocular motility changes after inferomedial wall and balanced medial plus lateral wall orbital decompression in Graves' orbitopathy: a randomized prospective comparative study

Ocular motility changes after inferomedial wall and balanced medial plus lateral wall orbital decompression in Graves' orbitopathy: a randomized prospective comparative study

Estudo comparativo dos resultados da descompressão orbitária inferomedial vs. balanceada em pacientes com Orbitopatia de Graves, por meio de análise tomográfica, fotográfica e clínica

A randomized comparative study of inferomedial vs. balanced orbital decompression. Analysis of changes in orbital volume, eyelid parameters, and eyeball position

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