Scientific letter
Evaluation of the outcomes following endonasal endoscopic orbital decompression in patients with Graves’ ophthalmopathy
Evaluación de los resultados después de la descompresión orbital endonasal endoscópica en pacientes con oftalmopatía de Graves
Justina Budeniene
, Antanas Budenas, Dalia Jarusaitiene
Corresponding author
Lithuanian University of Health Sciences, Lithuania
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Since the conservative therapy of severe GO do not often gives satisfactory results, those patients who develop severe proptosis, exposure keratopathy or compressive optic neuropathy require orbital surgical treatment. We investigated 21 patients with GO records who had undergone endoscopic transnasal medial and medial inferior wall orbital decompression. 5 patients with incomplete datasets and lack of ophthalmological postoperative data were excluded from the statistical calculations and 16 patients were eligible for data analysis. Ethical considerations have been validated by Lithuanian University of Health Sciences Bioethical center. The mean of patients age was 54 years. Mean proptosis reduction after orbital decompression was 3.8<span class="elsevierStyleHsp" style=""></span>mm, and during the follow up it was 3.2<span class="elsevierStyleHsp" style=""></span>mm. In 40% of patients visual acuity improved after orbital decompression. There was no new-onset constant diplopia after the operation. During follow-up after decompression 3 patients (18.8%) complained about new-onset of diplopia. After decompression in 2 (12.5%) patients developed new case of strabismus.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In our study proptosis reduction after the orbital endonasal decompression results were similar comparing to other researches<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,2</span></a> and were in range of 2–4<span class="elsevierStyleHsp" style=""></span>mm described in medical literature.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2,3</span></a> In our study orbital decompression also had effect on the visual acuity after the operation. Other researches showed that using medial and inferomedial approaches visual acuity improved in 60.8–67% of patients.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> But other authors found that there is no statistically significant differences in visual acuity among different combinations of orbital walls being decompressed.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Graham et al. found a low rate (10%) of new-onset diplopia in their patients who underwent medial and lateral decompression.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> In other studies strabismus rate vary from 7% to up to 30% depending on surgical technique.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In conclusion, endonasal endoscopic orbital decompression is safe and effective in reducing proptosis, improving visual acuity and cosmesis in patients with Graves’ ophthalmopathy. But, the risk of increasing postoperative diplopia requiring corrective eye muscle surgery or prisms is still considerable.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Thyroid-related orbital decompression surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Wu" 1 => "L. Niziol" 2 => "D. Musch" 3 => "A. 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