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

Author:

Sellari-Franceschini Stefano1,Berrettini Stefano1,Santoro Amelia1,Nardi Marco2,Mazzeo Salvatore3,Bartalena Luigi4,Mazzi Barbara5,Tanda Maria Laura4,Marcocci Claudio5,Pinchera Aldo5

Affiliation:

1. From the Department of Neuroscience, Ia ENT division

2. Ophthalmology Division, the Department of Oncology, Transplants

3. Advanced Technologies in Medicine, Diagnostic and Interventional Radiology Division

4. the Department of Clinical and Biological Science, University Insubria, Varese.

5. the Department of Endocrinology and Metabolism, Orthopaedics and Traumatology, Occupational Medicine, University of Pisa

Abstract

Objective The objective of this study is to describe a technique for balanced orbital decompression and to analyze the results. Methods and Materials 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. Results 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. Conclusions 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.

Publisher

SAGE Publications

Subject

Otorhinolaryngology,Surgery

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