Lateral wall orbital decompression in Graves’ orbitopathy

Abstract Orbital decompression can be carried out, for rehabilitative reasons, using various techniques, but a general consensus on the ideal surgical approach has not been reached. Postoperative diplopia is the most common side effect of decompression surgery. The authors report 39 patients (72 orb...

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Bibliographic Details
Published in:International journal of oral and maxillofacial surgery 2010-01, Vol.39 (1), p.16-20
Main Authors: Sellari-Franceschini, S, Lenzi, R, Santoro, A, Muscatello, L, Rocchi, R, Altea, M.A, Nardi, M, Megna, L, Marcocci, C
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Blood Loss, Surgical
Conjunctival Diseases - etiology
Decompression, Surgical - methods
Dentistry
Diplopia - etiology
Dura Mater - injuries
Edema - etiology
exophthalmos
Exophthalmos - pathology
Exophthalmos - surgery
Feasibility Studies
Female
Follow-Up Studies
Graves Ophthalmopathy - pathology
Graves Ophthalmopathy - surgery
Graves’ ophthalmopathy
Humans
Hypesthesia - etiology
Male
Medical sciences
Middle Aged
Ophthalmology
orbit
Orbit - innervation
Orbit - surgery
Orbit diseases
Osteotomy - methods
Otorhinolaryngology. Stomatology
Postoperative Complications
Retrospective Studies
Safety
Surgery
surgical decompression
Visual Acuity - physiology
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Summary:Abstract Orbital decompression can be carried out, for rehabilitative reasons, using various techniques, but a general consensus on the ideal surgical approach has not been reached. Postoperative diplopia is the most common side effect of decompression surgery. The authors report 39 patients (72 orbits) who underwent lateral wall orbital decompression. Mean preoperative and postoperative Hertel exophthalmometry were 22.8 ± 2.2 mm (mean ± SD; range 16–26 mm) and 18.2 ± 2.1 mm (range 15–22 mm), respectively. Mean proptosis reduction was 4.5 ± 1.9 mm. A new appearance of diplopia postoperatively in the extreme gaze direction was observed in three patients (8%). The complication rate in this series was low, making the procedure safe and well tolerated. In the authors’ opinion, when a single-wall approach is feasible, lateral wall decompression should be the first choice because of its effectiveness in terms of proptosis reduction and safeness in terms of postoperative diplopia.
ISSN:0901-5027
1399-0020
DOI:10.1016/j.ijom.2009.10.011