A systematic review of outcomes following surgical decompression for dysthyroid orbitopathy

Leong, Samuel; Karkos, Petros D.; MacEwen, C J; White, Paul S.

doi:10.1002/lary.20213

Cited by 91 publications

(85 citation statements)

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“…22,23 Our observed ratio (0.9) may be attributed to the inclusion of fewer patients with an erratic distribution of the disease, resulting in an incomplete picture of DO. Our mean (SD) patient body mass index of 24.9 (3.3) was comparable to the 24.8 (3.7) in a study of patients with Graves disease by Ozata et al 24 Smokers experience more severe DO than nonsmokers.…”

Section: Discussionmentioning

confidence: 63%

“…The mean age herein for both sexes was 43 years, which was identical to the mean age in the study of outcomes following surgical decompression by Leong et al 23 Graves disease herein followed the trend of female preponderance, with sex ratios of 2.0 and 3.3 in the literature. 22,23 Our observed ratio (0.9) may be attributed to the inclusion of fewer patients with an erratic distribution of the disease, resulting in an incomplete picture of DO.…”

Section: Discussionmentioning

confidence: 90%

See 1 more Smart Citation

Proptosis Reduction by Clinical vs Radiological Modalities and Medial vs Inferomedial Approaches

Thapa

Gupta

et al. 2015

JAMA Otolaryngol Head Neck Surg

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 90%

Proptosis Reduction by Clinical vs Radiological Modalities and Medial vs Inferomedial Approaches

Thapa

Gupta

et al. 2015

JAMA Otolaryngol Head Neck Surg

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“…A number of reports have described the outcome of orbital decompressions (Leong et al 2009;Mourits et al 2009;Leong & White 2010). Most have focussed on the short-term recovery.…”

Section: Introductionmentioning

confidence: 99%

Long‐term follow‐up of patients with thyroid eye disease treated with endoscopic orbital decompression

Gulati

Ueland

Haugen

et al. 2014

Acta Ophthalmologica

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ABSTRACT.Purpose: To evaluate the outcome of endoscopic decompression in a series of patients with thyroid eye disease. Methods: All 46 patients operated at our institution in the period 2001 to 2011 were invited for re-examination. Thirty-seven patients were included in the study and underwent a general otorhinolaryngological and ophthalmological examination. Nasal endoscopy, autoperimetry and a CT scan of the orbits and paranasal sinuses were performed. Preoperative and early postoperative data were obtained from hospital records. Re-examination was performed from 12 months to 9 years postoperatively. Paired t-test was used to evaluate the change in pre-and postoperative data. Image-guided surgery was used in two patients. Results: Visual acuity improved from a median value (range) of 0.8 (0.05-1.25) to 1.0 (0.4-1.25) (p = 0.006). Intra-ocular pressure (IOP) was reduced from a median value (range) of 18 mmHg (10-27 mmHg) to 14 mmHg (8-24 mmHg) (p < 0.001). Median (range) Hertel values were 22.5 mm (14-29 mm) preoperatively and 19 mm (11-26 mm) postoperatively (p < 0.001). Mean reduction in proptosis was 4.0 mm. At follow-up, visual fields were normal in 16/37 patients (43%) and with small defects in 12/37 patients (32%). Seventeen patients (46%) had diplopia preoperatively in one or more directions of gaze while 9 (24%) suffered from constant diplopia. After endoscopic decompression, new onset diplopia was seen in seven (19%) individuals, while worsening of diplopia occurred in eight (22%). Impaired motility in abduction and/or elevation was seen in 20 (54%) individuals before decompression and in 23 (62%) after. Strabismus surgery was performed in 22 patients. On final examination 85% of the study population were totally free of diplopia or experienced diplopia only in the peripheral field of gaze. Three patients developed sinusitis. Of these, endoscopic sinus surgery was performed in two patients, and one patient was conservatively treated. Symptoms resolved in all three patients. Conclusion: Endoscopic medial orbital decompression including removal of the medial floor of the orbit is a safe and effective procedure for treatment of thyroid eye disease. Navigation can be of valuable help to ensure complete resection of the bony walls. However, the majority of patients will need subsequent strabismus surgery, mainly due to significant increase of esotropia.

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“…Major complication rates are less than 1%; however, these include orbital and carotid artery injuries, which are potentially devastating for the patient [6]. ESS is also now being extended to include the management of dysthyroid eye disease and epiphora [7,8], and the surgical management of benign [9,10] and malignant [11] sinonasal and skull base tumours.…”

Section: Brief Overview Of Endoscopic Sinus Surgerymentioning

confidence: 99%

The Role of Simulation in Endoscopic Sinus Surgery Training

Stew¹,

Ooi²

2017

Paranasal Sinuses

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Surgical simulation is an efective tool used to teach many of the fundamental skills required to be a surgeon. Simulation-based education with directed practice in surgical training allows repeated practice in an environment to learn surgical skills, which do not cause harm to patients. There are several simulators developed for endoscopic sinus surgery training. Some simulators have undergone validation studies with regard to developing skills necessary to perform endoscopic sinus surgery. This book chapter will review the currently available sinus surgery simulators that have undergone validation and evaluate their potential role in surgical training.

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A systematic review of outcomes following surgical decompression for dysthyroid orbitopathy

Abstract: There are myriad techniques in practice for decompressing the orbit, but no one technique has yet to achieve consistently good outcome and low complication rates. The reporting of outcomes should conform to a minimum dataset. Laryngoscope, 2009.

Cited by 91 publications

References 9 publications

Proptosis Reduction by Clinical vs Radiological Modalities and Medial vs Inferomedial Approaches

Proptosis Reduction by Clinical vs Radiological Modalities and Medial vs Inferomedial Approaches

Long‐term follow‐up of patients with thyroid eye disease treated with endoscopic orbital decompression

The Role of Simulation in Endoscopic Sinus Surgery Training

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