Endoscopic orbital decompression for Graves’ ophthalmopathy

Wee, Desmond T. H.; Carney, A. Simon; Thorpe, Mark; Wormald, Peter John

doi:10.1258/0022215021910195

Cited by 27 publications

(23 citation statements)

References 24 publications

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“…Our experience of a mean regression of proptosis of about 3.70 mm is similar to what has been reported in previous studies adopting a similar approach[89101112131415] [Table 4] and comparable to the reduction of 3 to 5.5 mm reported from the non-endoscopic Walsh Ogura technique. [1617]…”

Section: Discussionsupporting

confidence: 89%

Endoscopic orbital decompression for Graves′ orbitopathy

Lal

Thakar

Tandon

2013

Indian J Endocr Metab

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Aim:To study the efficacy of endonasal endoscopic orbital decompression in cases of Graves’ orbitopathy.Material and Methods:A total of 24 orbits in 12 patients underwent endoscopic orbital decompression for graves orbitopathy in the period between October 2002 and December 2010. Indications for surgery included proptosis, corneal exposure, keratitis, and compressive optic neuropathy. Decompression was accomplished by the removal of the medial and part of inferior wall of the orbit and slitting of the orbital periosteum. Pre and postoperative exophthalmometry measurements and visual acuity were recorded and compared.Results:A mean orbital regression of 3.70 mm was noted following endoscopic decompression. The visual acuity improved significantly in one of two eyes decompressed for failing visual acuity secondary to optic nerve compression. Transient diplopia was invariable following surgery but resolved over the next 8 weeks. One case manifested unilateral frontal sinus obstruction symptoms 4 months postoperatively and responded to medical therapy.Conclusion:Endonasal endoscopic orbital decompression provides for an effective, safe, and minimally invasive treatment for proptosis and visual loss of Graves Orbitopathy. Long-term problems with diplopia were not noted in the endonasal endoscopic approach for orbital decompression.

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Section: Discussionsupporting

confidence: 89%

Endoscopic orbital decompression for Graves′ orbitopathy

Lal

Thakar

Tandon

2013

Indian J Endocr Metab

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“…In our study, the horizontal distances from the MOF to the ION at the depth of the AE and BL were approximately more than 10 mm. Those results could support the concept that it would be difficult to injure the ION by orbital floor removal in endoscopic orbital decompression [15]. …”

Section: Discussionsupporting

confidence: 54%

“…The ION is used as the landmark for endoscopic orbital decompression and endoscopic approach of the pterygopalatine fossa [15,16]. In our study, the horizontal distances from the MOF to the ION at the depth of the AE and BL were approximately more than 10 mm.…”

Section: Discussionmentioning

confidence: 59%

Anatomical Analysis of Intraorbital Structures Regarding Sinus Surgery Using Multiplanar Reconstruction of Computed Tomography Scans

Hwang

Park

Cho

et al. 2013

Clin Exp Otorhinolaryngol

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ObjectivesThis study aimed to investigate the anatomy of the intraorbital structures regarding to endoscopic sinus surgery and external frontal sinus surgery analyzing computer tomography (CT) scans.MethodsThe CT scans of 100 patients were retrospectively evaluated. The anatomic relationships between the intraorbital structures and paranasal structures were measured using multiplanar reconstruction of the CT scan.ResultsThe mean distances from the medial orbital floor (MOF) to the intraorbital structures were measured at the depth of the anterior ethmoid (AE), basal lamella (BL), and midportion of posterior ethmoid (PE) in the coronal planes respectively. The mean distances from the MOF to the medial rectus muscle and inferior rectus muscle at the depth of AE were approximately 8 mm and those distances in the BL and PE decreased rapidly. The mean distances from the MOF to the infraorbital nerve at the depth of the AE and BL were approximately more than 10 mm. The mean distances from the vertical axis, which passed through the MOF, to the superior oblique muscle and optic nerve at the depth of the PE were approximately 5 mm medially and 1 mm laterally. In addition, the mean distance from the midline to the trochlea of the superior oblique muscle was approximately 15 mm.ConclusionsThose measurements provide spatial information on the placements of the extraocular muscles within the orbit. The measurements will contribute to the avoidance of orbital complications during sinus surgery.

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“…The Caldwell-Luc procedure combined with endoscopy is described by Rizk et al [27], who identified the infraorbital nerve before removing the median portion of the orbital floor of the orbit. The pathway of the infraorbital triad is used as an important landmark during endoscopic orbital decompression for thyroid ophthalmopathy such as the Walsh-Ogura procedure [2,17,31]. It is emphasised that the region of the infraorbital canal and groove is crucial in surgical reconstructions [1].…”

Section: Discussionmentioning

confidence: 99%