Orbital Decompression in Graves’ Ophthalmopathy by Medial and Lateral Wall Removal

The objective of this study is to describe a technique for balanced orbital decompression and to analyze the results. We conducted a retrospective study of 140 patients (276 orbits). Orbital decompression was carried out by removal of the medial orbital wall by ethmoidectomy and complete removal of...

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Bibliographic Details
Published in:Otolaryngology-head and neck surgery 2005-08, Vol.133 (2), p.185-189
Main Authors: Sellari-Franceschini, Stefano, Berrettini, Stefano, Santoro, Amelia, Nardi, Marco, Mazzeo, Salvatore, Bartalena, Luigi, Mazzi, Barbara, Tanda, Maria Laura, Marcocci, Claudio, Pinchera, Aldo
Format: Article
Language:English
Subjects:
Adult
Aged
Cohort Studies
Decompression, Surgical - methods
Ethmoid Sinus - surgery
Exophthalmos - etiology
Exophthalmos - surgery
Female
Follow-Up Studies
Graves Disease - complications
Graves Disease - diagnostic imaging
Humans
Male
Middle Aged
Ophthalmologic Surgical Procedures - methods
Orbit - surgery
Postoperative Complications
Retrospective Studies
Risk Assessment
Tomography, X-Ray Computed
Treatment Outcome
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Summary:The objective of this study is to describe a technique for balanced orbital decompression and to analyze the results. We conducted a retrospective study of 140 patients (276 orbits). Orbital decompression was carried out by removal of the medial orbital wall by ethmoidectomy and complete removal of the lateral wall by bringing out the entire sphenoid wing together with part of the zygomatic bone down to the inferior orbital fissure. One hundred thirty-six patients underwent bilateral decompression, 4 patients underwent monolateral decompression. Proptosis was reduced on average by 5.3 mm; 28 (20%) patients showed onset or worsening of diplopia. Medial and lateral approach allows a balanced orbital decompression. As some patients may present different degrees of proptosis and visual impairment, we stress the importance of carefully weighing the preoperative conditions of the individual patient when choosing the surgical approach.
ISSN:0194-5998
1097-6817
DOI:10.1016/j.otohns.2005.02.006