Skip to main content
NCBI home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1996 Jan;80(1):58–62. doi: 10.1136/bjo.80.1.58

Effects of bilateral orbital decompression by an endoscopic endonasal approach in dysthyroid orbitopathy.

A Neugebauer 1, K Nishino 1, P Neugebauer 1, W Konen 1, O Michel 1
PMCID: PMC505385  PMID: 8664235

Abstract

AIMS: The efficacy of endoscopic endonasal orbital decompression in dysthyroid orbitopathy was analysed. METHODS: In 21 consecutive cases of bilateral operation short term (10 (SD 6) days after operation) and long term (156 (12) days after operation) results were recorded. RESULTS: Short term results showed that vision of the more affected eye improved from a mean of 0.35 to 0.59; vision improved in all but one eye which remained unchanged. In the fellow eyes mean visual acuity improved from 0.6 to 0.7; three of these eyes showed a decrease. Mean proptosis returned from 23.0 mm to 20.0 mm. As to motility the mean abductive capacity decreased from 5.5 mm to 4.0 mm of monocular excursion, whereas adduction increased from 7.5 mm to 8.5 mm. Upgaze and downgaze did not show any major change. The mean angle of horizontal squint shifted from 7.5 degrees of convergence to 15.5 degrees while no significant vertical or cyclorotational deviation was induced. These immediate postoperative results proved to be stable for the period of long term follow up with only slight changes. No significant bleeding or specific otorhinolaryngological complication without resolve occurred intraoperatively or perioperatively. CONCLUSION: This method is believed to be superior to non-endoscopic techniques because it avoids external scars and antral pain. With regard to the relief of intraorbital pressure, the technique gives good results for visual acuity improvement, but in proptosis reduction the method is not as efficient as external or combined procedures. There seems to be no difference when compared with other approaches in induction of horizontal squint. The method has a protective long term effect against the recurrence of compressive optic neuropathy.

Full text

PDF
58

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Carter K. D., Frueh B. R., Hessburg T. P., Musch D. C. Long-term efficacy of orbital decompression for compressive optic neuropathy of Graves' eye disease. Ophthalmology. 1991 Sep;98(9):1435–1442. doi: 10.1016/s0161-6420(91)32115-8. [DOI] [PubMed] [Google Scholar]
  2. Garrity J. A., Fatourechi V., Bergstralh E. J., Bartley G. B., Beatty C. W., DeSanto L. W., Gorman C. A. Results of transantral orbital decompression in 428 patients with severe Graves' ophthalmopathy. Am J Ophthalmol. 1993 Nov 15;116(5):533–547. doi: 10.1016/s0002-9394(14)73194-0. [DOI] [PubMed] [Google Scholar]
  3. Jorissen M., Feenstra L. Dysthyroid orbitopathy and orbital decompression. A review. Acta Otorhinolaryngol Belg. 1992;46(3):303–309. [PubMed] [Google Scholar]
  4. Kennedy D. W., Goodstein M. L., Miller N. R., Zinreich S. J. Endoscopic transnasal orbital decompression. Arch Otolaryngol Head Neck Surg. 1990 Mar;116(3):275–282. doi: 10.1001/archotol.1990.01870030039006. [DOI] [PubMed] [Google Scholar]
  5. Kulwin D. R., Cotton R. T., Kersten R. C. Combined approach to orbital decompression. Otolaryngol Clin North Am. 1990 Jun;23(3):381–390. [PubMed] [Google Scholar]
  6. Mann W., Kahaly G., Lieb W., Rothoff T., Springborn S. Orbital decompression for endocrine ophthalmopathy: the endonasal approach. Dev Ophthalmol. 1993;25:142–150. doi: 10.1159/000422433. [DOI] [PubMed] [Google Scholar]
  7. Michel O., Bresgen K., Rüssmann W., Thumfart W. F., Stennert E. Endoskopisch kontrollierte endonasale Orbitadekompression beim malignen Ophthalmus. Laryngorhinootologie. 1991 Dec;70(12):656–662. doi: 10.1055/s-2007-998119. [DOI] [PubMed] [Google Scholar]
  8. Mourits M. P., Koornneef L., Wiersinga W. M., Prummel M. F., Berghout A., van der Gaag R. Orbital decompression for Graves' ophthalmopathy by inferomedial, by inferomedial plus lateral, and by coronal approach. Ophthalmology. 1990 May;97(5):636–641. doi: 10.1016/s0161-6420(90)32532-0. [DOI] [PubMed] [Google Scholar]
  9. Mourits M. P., Prummel M. F., Wiersinga W. M., Koornneef L. Measuring eye movements in Graves ophthalmopathy. Ophthalmology. 1994 Aug;101(8):1341–1346. doi: 10.1016/s0161-6420(94)31164-x. [DOI] [PubMed] [Google Scholar]
  10. Mourits M. P., Prummel M. F., Wiersinga W. M., Koornneef L. Measuring eye movements in Graves ophthalmopathy. Ophthalmology. 1994 Aug;101(8):1341–1346. doi: 10.1016/s0161-6420(94)31164-x. [DOI] [PubMed] [Google Scholar]
  11. Trobe J. D. Optic nerve involvement in dysthyroidism. Ophthalmology. 1981 Jun;88(6):488–492. doi: 10.1016/s0161-6420(81)34997-5. [DOI] [PubMed] [Google Scholar]
  12. WALSH T. E., OGURA J. H. Transantral orbital decompression for malignant exophthalmos. Laryngoscope. 1957 Jun;67(6):544–568. doi: 10.1288/00005537-195706000-00002. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES