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Updated: Aug 11, 2026
05:12
Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Combined endoscopic medial and external lateral orbital decompression for progressive thyroid eye disease
Robert D Silver1, Andrew R Harrison, George S Goding
1Department of Otolaryngology, University of Minnesota, Minneapolis 55455, USA.
Summary
Endoscopic medial and lateral orbital wall surgery effectively reduces proptosis and improves visual acuity in thyroid eye disease patients. This 2-wall approach offers comparable outcomes to 3-wall decompression with favorable results.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
Background:
- Thyroid eye disease (TED) can cause severe proptosis, exposure keratitis, and compressive optic neuropathy.
- Surgical orbital decompression is a key treatment for managing these complications.
Purpose of the Study:
- To compare the efficacy of endoscopic 2-wall (medial and lateral) orbital decompression with traditional 3-wall decompression in patients with TED.
Main Methods:
- A retrospective study was conducted on patients diagnosed with TED.
- Patients included had severe proptosis, exposure keratitis, or compressive optic neuropathy.
Main Results:
- Mean proptosis reduction was 4.37 mm for the 2-wall approach and 4.59 mm for the 3-wall approach.
- Visual acuity improved in 75% of the 2-wall group versus 50% in the 3-wall group.
- Vertical palpebral fissure height decreased by 2.50 mm (2-wall) and 2.03 mm (3-wall); new diplopia occurred in 11.8% (2-wall) and 12.5% (3-wall).
Conclusions:
- Endoscopic 2-wall orbital decompression demonstrates favorable outcomes in improving proptosis, visual acuity, and palpebral fissure height in TED patients.
- The efficacy of the 2-wall approach is comparable to 3-wall decompression for managing TED complications.
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