Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-27T19:04:32.340Z Has data issue: false hasContentIssue false

Orbital decompression for thyroid eye disease: a comparison of external and endoscopic techniques

Published online by Cambridge University Press:  29 June 2007

Valerie J. Lund*
Affiliation:
Department of Rhinology, The Royal National, Throat, Nose and Ear Hospital, London, UK
Genevieve Larkin
Affiliation:
Department of Rhinology, The Royal National, Moorfield's Eye Hospital, London, UK
Peter Fells
Affiliation:
Department of Rhinology, The Royal National, Moorfield's Eye Hospital, London, UK
Gillian Adams
Affiliation:
Department of Rhinology, The Royal National, Moorfield's Eye Hospital, London, UK
*
Address for correspondence: Professor Valerie J. Lund, The Royal National Throat, Nose and Ear Hospital, 330 Gray's Inn Road, London WC1X 8DA. Fax: 0171 8339480

Abstract

The results of orbital decompression for thyroid eye disease are presented in a cohort of 33 patients. It was performed by an external Patterson approach in 21 individuals and in 13 by an endonasal endoscopic approach. The endoscopic approach was entirely comparable in respect of improvement in axial proptosis, giving a mean improvement of 4.4 mm as compared with a mean of 3.8 mm for the external approach, and produced a demonstrable improvement in visual acuity and perception of colour in three individuals, where this was compromised, and was associated with fewer complications.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bahn, R. S., Heufelder, A. E. (1993) Pathogenesis of Graves' ophthalmopathy. New England Journal of Medicine 329: 14681475.Google ScholarPubMed
De Santo, L. W. (1980) The total rehabilitation of Graves' ophthalmopathy. Laryngoscope 90: 16521678.CrossRefGoogle ScholarPubMed
Dollinger, J. (1911) Die drickentlastlung der augenjokle durch entfurnung der aussern orbitalwand bei hochgradigen expohthalmos und koneskutwer hornhauterkrongkung. Deutsche Med Wochenschrift 37: 18881890.CrossRefGoogle Scholar
Garrity, J. A. (1994) The surgical management of Graves' ophthalmology. Current Opinion in Ophthalmology 5: 3944.CrossRefGoogle Scholar
Garrity, J. A., Fatourechti, V., Bergstralh, E. J., Bartley, G. B., Beatty, C. W., De Santo, L. W., Gorman, C. A. (1993) Results of transantral orbital decompression in 428 patients with severe Graves' ophthalmology. American Journal of Ophthalmology 116: 533547.CrossRefGoogle Scholar
Harrison, D. F. N. (1981) Surgical approaches to the medial orbital wall. Annals of Otology, Rhinology and Laryngology 90: 415419.CrossRefGoogle Scholar
Hirsch, O. (1950) Surgical decompression of exophthalmos. Archives of Otolaryngology – Head and Neck Surgery 51: 325331.CrossRefGoogle Scholar
Kennedy, D. W. (1985) Functional endoscopic sinus surgery technique. Archives of Otolaryngology – Head and Neck Surgery 111: 643649.CrossRefGoogle ScholarPubMed
Kennedy, D. W., Goodstein, M. L., Miller, N. R., Zinreich, S. J. (1990) Endoscopic transnasal orbital decompression. Archives of Otolaryngology – Head and Neck Surgery 116: 275282.CrossRefGoogle ScholarPubMed
Kraus, D. J., Bullock, J. D. (1993) Treatment of thyroid ocular myopathy with adjustable and nonadjustable suture strabismus surgery. Transactions of the American Ophthalmological Society 91: 6784.Google ScholarPubMed
Liu, D. (1993) Surgical correction of upper eyelid retraction. Ophthalmic Surgery 24: 323327.Google ScholarPubMed
Mann, W., Kahaly, G., Lieb, W., Rothoff, T., Springborn, S. (1993) Orbital decompression for endocrine ophthalmopathy. The endonasal approach. Developmental Ophthalmology 25: 142150.CrossRefGoogle ScholarPubMed
McCord, C. D. Jr. (1985) Current trends in orbital decompression. Ophthalmology 92: 2133.CrossRefGoogle ScholarPubMed
Metson, R., Dallow, R. L., Shore, J. W. (1994) Endoscopic orbital decompression. Laryngoscope 104: 950957.CrossRefGoogle ScholarPubMed
Naffziger, H. C. (1931) Progressive exophthalmos following thyroidectomy: its pathology and treatment. Annals of Surgery 94: 582586.CrossRefGoogle Scholar
Penttila, M. A., Rautiainen, M. E. P., Pukander, J. S., Karma, P. H. (1994) Endoscopic versus Caldwell-Luc approach in chronic maxillary sinusitis: Comparison of symptoms at oneyear follow-up. Rhinology 32: 161165.Google ScholarPubMed
Sewall, E. C. (1936) Operative control of progressive exophthalmos. Archives of Otolaryngology – Head and Neck Surgery 24: 621624.CrossRefGoogle Scholar
Stammberger, H. (1985) Endoscopic endonasal surgery – new concepts in treatment of recurring sinusitis. Part II. Surgical technique. Otolaryngology – Head and Neck Surgery 94: 147156.CrossRefGoogle Scholar
Stark, B., Olivari, N. (1993) Treatment of exophthalmos by orbital fat removal. Clinics in Plastic Surgery 20: 285289.CrossRefGoogle ScholarPubMed
Trokel, S., Kazim, M., Moore, S. (1993) Orbital fat removal: decompression for Graves' orbitopathy. Ophthalmology 100: 674682.CrossRefGoogle ScholarPubMed
Walsh, T. E., Ogura, J. H. (1957) Transantral orbital decompression for malignant exophthalmos. Laryngoscope 67: 544549.CrossRefGoogle ScholarPubMed
Warren, J. D., Spector, J. G., Burde, R. (1989) Long-term follow-up and recent observations on 305 cases of orbital decompression for dysthyroid orbitopathy. Laryngoscope 99: 3540.CrossRefGoogle ScholarPubMed