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[Endoscopic trans-ethmoid medial orbital wall decompression combined with intraconal fat decompression for Graves' ophthalmopathy].

Abstract

OBJECTIVE

To present a new mini-invasive surgery for compressive optic neuropathy (CON) in Graves' ophthalmopathy (GO) by adequately decompressing the orbital apex and correcting proptosis, and to analyze its results.

METHODS

A retrospective chart was reviewed in 29 patients receiving orbital decompression for the treatment of CON secondary to GO from October 2006 to May 2011. All patients diagnosed CON were in stable and inactive phase of GO at least for 6 months. All patients received endoscopic transethmoid medial orbital wall decompression to reduce the compression on the orbital apex. In the meanwhile, an endoscopic transethmoid intraconal fat-removal orbital decompression was performed to remove parts of intraconal fat with a special aspiration/cutting instrument to further reduce the proptosis. All patients were followed up periodically.

RESULTS

of improvement of visual acuity (VA), color vision, and amount of proptosis reduction and incidence of induced diplopia 9 months after surgery was recorded for analysis its feasibility.

RESULTS

Forty-five orbits of 29 patients were included in the study. At the 9 months review, 44 of 45 eyes (97.8%) improved their VA from -0.65±0.30 (x±s) preoperatively to -0.24±0.22, with a mean improvement of 0.55±0.17 (t=-13.012, P<0.001), 23 of 29 eyes (79.3%) had improved color vision (P<0.001), and the mean reduction in proptosis was (7.07±1.59) mm (range 4-11 mm). Postoperative symmetry to within 2 mm were achieved in all patients. Except 1 patient complaining of deterioration in diplopia following surgery, no patients presented new on-set diplopia postoperatively.

CONCLUSION

The endoscopic transethmoid medial orbital wall decompression combined with the endoscopic transethmoid intraconal fat-removal orbital decompression is an effective treatment with minimal morbidity for both visional recovery and improvement of proptosis for CON in GO.

Authors+Show Affiliations

The Eye Hospital of Wenzhou Medical College, Wenzhou 325027, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

chi

PubMed ID

22321417

Citation

Wu, Wen-can, et al. "[Endoscopic Trans-ethmoid Medial Orbital Wall Decompression Combined With Intraconal Fat Decompression for Graves' Ophthalmopathy]." Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi = Chinese Journal of Otorhinolaryngology Head and Neck Surgery, vol. 46, no. 10, 2011, pp. 807-13.
Wu WC, Yu B, Wang ML, et al. [Endoscopic trans-ethmoid medial orbital wall decompression combined with intraconal fat decompression for Graves' ophthalmopathy]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011;46(10):807-13.
Wu, W. C., Yu, B., Wang, M. L., Huang, L., Tu, Y. H., Chen, B., Qu, J., & Wang, Q. M. (2011). [Endoscopic trans-ethmoid medial orbital wall decompression combined with intraconal fat decompression for Graves' ophthalmopathy]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi = Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 46(10), 807-13.
Wu WC, et al. [Endoscopic Trans-ethmoid Medial Orbital Wall Decompression Combined With Intraconal Fat Decompression for Graves' Ophthalmopathy]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011;46(10):807-13. PubMed PMID: 22321417.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Endoscopic trans-ethmoid medial orbital wall decompression combined with intraconal fat decompression for Graves' ophthalmopathy]. AU - Wu,Wen-can, AU - Yu,Bo, AU - Wang,Ming-ling, AU - Huang,Ling, AU - Tu,Yun-hai, AU - Chen,Ben, AU - Qu,Jia, AU - Wang,Qin-mei, PY - 2012/2/11/entrez PY - 2012/2/11/pubmed PY - 2012/5/11/medline SP - 807 EP - 13 JF - Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery JO - Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi VL - 46 IS - 10 N2 - OBJECTIVE: To present a new mini-invasive surgery for compressive optic neuropathy (CON) in Graves' ophthalmopathy (GO) by adequately decompressing the orbital apex and correcting proptosis, and to analyze its results. METHODS: A retrospective chart was reviewed in 29 patients receiving orbital decompression for the treatment of CON secondary to GO from October 2006 to May 2011. All patients diagnosed CON were in stable and inactive phase of GO at least for 6 months. All patients received endoscopic transethmoid medial orbital wall decompression to reduce the compression on the orbital apex. In the meanwhile, an endoscopic transethmoid intraconal fat-removal orbital decompression was performed to remove parts of intraconal fat with a special aspiration/cutting instrument to further reduce the proptosis. All patients were followed up periodically. RESULTS: of improvement of visual acuity (VA), color vision, and amount of proptosis reduction and incidence of induced diplopia 9 months after surgery was recorded for analysis its feasibility. RESULTS: Forty-five orbits of 29 patients were included in the study. At the 9 months review, 44 of 45 eyes (97.8%) improved their VA from -0.65±0.30 (x±s) preoperatively to -0.24±0.22, with a mean improvement of 0.55±0.17 (t=-13.012, P<0.001), 23 of 29 eyes (79.3%) had improved color vision (P<0.001), and the mean reduction in proptosis was (7.07±1.59) mm (range 4-11 mm). Postoperative symmetry to within 2 mm were achieved in all patients. Except 1 patient complaining of deterioration in diplopia following surgery, no patients presented new on-set diplopia postoperatively. CONCLUSION: The endoscopic transethmoid medial orbital wall decompression combined with the endoscopic transethmoid intraconal fat-removal orbital decompression is an effective treatment with minimal morbidity for both visional recovery and improvement of proptosis for CON in GO. SN - 1673-0860 UR - https://www.unboundmedicine.com/medline/citation/22321417/[Endoscopic_trans_ethmoid_medial_orbital_wall_decompression_combined_with_intraconal_fat_decompression_for_Graves'_ophthalmopathy]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&amp;issn=1673-0860&amp;year=2011&amp;vol=46&amp;issue=10&amp;fpage=807 DB - PRIME DP - Unbound Medicine ER -