Orbital decompression by endoscopic transnasal and transantral approach in thyroid-associated ophthalmopathy

Year 2002, Volume: 9 Issue: 5, 358 - 362, 10.10.2002

Harun Cansız Kemal Tuskan Nuran Kalekoğlu Özcan Öztürk Ender İnci Nihat Şekercioğlu Halit Pazarlı

Abstract

Objectives: We evaluated the results of orbital decom­ pression in patients with Graves’ disease.Patients and Methods: Orbital decompression was performed by endoscopic transnasal medial wall approach and transantral inferior wall approach in 18 eyes of 12 patients 8 males, 4 females; mean age 41 years; range 24 to 65 years . The degree of exophthalmos was evaluated with the use of the Hertel exophthalmometer preoperatively, and postoperatively in the 24th hour, first and third months.Results: At the end of the third month, exophthalmos decreased by a mean of 4.4 mm range 3 to 7 mm .Visual acuity and field defects improved considerably in ali patients. Complications occurred in three cases 25% including diplopia, displacement of one eye infe- riorly, and maxillary sinusitis caused by the encroach- ment of the adipose tissue upon the ostium.Conclusion: With the increasing ease of surgical pro- cedures and enhanced experience on the part of surgeons, successful treatment of exophthalmos has become possible with decreased complication rates.

Keywords

Decompression, surgical/methods, endoscopy, exophthalmos/surgery, Graves' disease/surgery/radiography, nasal cavity, ocular motility disorders/etiology, oculomotor muscles, orbit/surgery, tomography, X-ray computed, treatment outcome, Vision disorders/surgery, visual acuity

Tiroit oftalmopatisinde transantral ve endoskopik transnazal yolla orbital dekompresyon

Abstract

Amaç: Graves hastalığında uyguladığımız orbital dekompresyonun sonuçlarını değerlendirdik.Hastalar ve Yöntemler: On iki hastanın 18 gözüne, medial duvara endoskopik transnazal ve inferior duvara transantral yaklaflımla orbital dekompresyon uygulandı. Olguların eksoftalmi dereceleri ameliyat öncesinde, ameliyattan sonra 24. saatte, birinci ve üçüncü aylarda Hertelölçüm aletiyle değerlendirildi.Bulgular: Üçüncü ayın sonunda eksoftalmide ortalamagerileme miktarı 4.44 mm dağılım 3-6 mm bulundu.Tüm olguların görme keskinliğinde ve görme alanı defektlerinde belirgin iyileflme görüldü. Üç olguda %25 komplikasyon geliflti; bunlar bir olguda diplopi, bir olguda gözün aflağı deplasmanı, bir olguda da prolabe olanyağ dokusunun yol açtığı maksiller sinüzitti.Sonu ç : Gerek cerrahi giriflimin uygulanmasındaki kolaylık, gerekse uygulanan teknik üzerinde cerrahların giderekdeneyim kazanması, eksoftalmosun baflarılı flekilde tedavi edilmesini ve komplikasyonların azalmasını sağlamıfltır

Keywords

Dekompresyon, cerrahi/yöntem, endoskopi, eksoftalmos/cerrahi, Graves hastalığı/cerrahi/radyografi, nazalkavite, oküler motilite bozuklukları/etyoloji, okülomotor kasları, orbit/cerrahi, bilgisayarlı tomografi, tedavi sonucu, görme bozuklukları/cerrahi, görme keskinliği

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