Combined endoscopic medial and external lateral orbital decompression for progressive thyroid eye disease

Otolaryngol Head Neck Surg. 2006 Feb;134(2):260-6. doi: 10.1016/j.otohns.2005.10.018.

Abstract

Objective: To compare the efficacy of endoscopic medial and lateral orbital wall surgery to 3-wall decompression in patients with thyroid eye disease.

Study design and setting: A retrospective study of patients with thyroid eye disease with severe proptosis, exposure keratitis, or compressive optic neuropathy was conducted.

Results: Mean reduction in proptosis was 4.37 mm in the 2-wall approach and 4.59 mm in the 3-wall group. Seventy-five percent of patients in the 2-wall group demonstrated improved visual acuity; 50% improved after 3-wall decompression. Vertical palpebral fissure height decreased by an average of 2.50 mm in the 2-wall group and by 2.03 mm in the 3-wall group. New onset diplopia was 11.8% and 12.5%, respectively.

Conclusions: Improvement in the degree of proptosis, visual acuity, and palpebral fissure height was seen in the majority of our patients and compared favorably to our results with 3-wall orbital decompression.

MeSH terms

  • Decompression, Surgical / methods*
  • Endoscopy
  • Graves Ophthalmopathy / surgery*
  • Humans
  • Ophthalmologic Surgical Procedures / methods*
  • Orbit / surgery*
  • Retrospective Studies
  • Visual Acuity