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Updated: Jul 14, 2026
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Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Beveled osteotomy with lateral wall advancement and interpositional bone grafting for severe thyroid orbitopathy
Grant D Gilliland1, Evan Clayton
1Department of Ophthalmology, Baylor University Medical Center, Dallas, TX 75204, USA. grantg1@sbcglobal.net
Ophthalmic Plastic and Reconstructive Surgery
|May 24, 2007
Summary
A new orbital decompression technique for thyroid eye disease significantly reduces proptosis and intraocular pressure. This method advances the lateral orbital wall, promoting bone healing and minimizing cosmetic deformities for improved patient outcomes.
Area of Science:
- Ophthalmology
- Plastic Surgery
- Neurosurgery
Background:
- Thyroid orbitopathy causes severe proptosis and vision issues.
- Traditional orbital decompression can lead to complications and cosmetic concerns.
Purpose of the Study:
- Introduce a novel orbital decompression technique for severe thyroid orbitopathy.
- Maximize orbital decompression while minimizing complications and cosmetic deformities.
- Promote osseous union of the advanced lateral orbital wall.
Main Methods:
- Case series of 42 eyes from 26 patients undergoing orbital decompression.
- Utilized a graded balanced orbital decompression with lateral wall advancement and bone grafts.
- Tabulated and statistically analyzed preoperative and postoperative measurements.
Main Results:
- Significant improvement in proptosis (average 8 mm reduction in exophthalmometry).
- Reduced intraocular pressure in 22 patients (average 7 mm Hg improvement).
- Improved visual acuity in 54% of patients; no new strabismus or decreased vision.
Conclusions:
- Graded balanced orbital decompression with bone grafts is effective for severe thyroid orbitopathy.
- The technique improves visual acuity, exophthalmometry, and intraocular pressure.
- Promotes osseous union and minimizes cosmetic deformities.
