Orbital Decompression for Exorbitism and Exophthalmos in a Patient With Thyroid Eye Disease

J Craniofac Surg. 2020 Jul-Aug;31(5):e477-e479. doi: 10.1097/SCS.0000000000006442.

Abstract

A 34-year-old man with Basedow disease consulted us to treat disfiguring proptosis. On examination, the patient showed right lower eyelid retraction and right inferior rectus muscle enlargement, which were consistent with thyroid eye disease. Hertel's exophthalmometric examination demonstrated proptosis of 25.5 and 24.0 mm on the right and left sides, respectively. Computed tomography (CT) images revealed absence of the sphenoid door jamb. To correct both exorbitism and exophthalmos, the patient underwent bilateral "shallow" decompression of the lateral and medial orbital walls with orbital fat removal under general anesthesia. The authors removed 2.5 and 1.0 mL of orbital fat from the inferolateral quadrant of the right and left orbits, respectively. At 3 months postoperatively, based on the measurements of the axial globe position on sagittal CT images, postoperative proptosis reductions of 7.5 and 6.5 mm were observed on the right and left sides, respectively.

Publication types

  • Case Reports

MeSH terms

  • Adipose Tissue / surgery
  • Adult
  • Decompression, Surgical*
  • Exophthalmos / diagnostic imaging
  • Exophthalmos / etiology
  • Exophthalmos / surgery*
  • Graves Ophthalmopathy
  • Humans
  • Male
  • Oculomotor Muscles / surgery
  • Orbit / diagnostic imaging
  • Orbit / surgery*
  • Postoperative Period
  • Sphenoid Bone / surgery
  • Thyroid Diseases / complications
  • Thyroid Diseases / diagnostic imaging
  • Thyroid Diseases / surgery*
  • Tomography, X-Ray Computed