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Published on: October 13, 2017
Transnasal endoscopic orbital decompression: 15-year clinical experience in Southern Taiwan
Yun-Ying She1, Chao-Chuan Chi1, Sau-Tung Chu1
1Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, ROC; Department of Otolaryngology-Head and Neck Surgery, National Defense Medical Centre & Tri-Service General Hospital, Taipei, Taiwan.
Endoscopic transnasal orbital decompression significantly reduces proptosis and intraocular pressure in dysthyroid orbitopathy patients. This minimally invasive procedure also improves visual acuity and relieves eye exposure, offering favorable cosmetic outcomes with rare complications.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
- Surgical Innovation
Background:
- Dysthyroid orbitopathy presents significant challenges affecting vision and appearance.
- Orbital decompression surgery is a key treatment for managing severe dysthyroid orbitopathy.
- Endoscopic transnasal approaches offer a minimally invasive alternative for orbital decompression.
Purpose of the Study:
- To evaluate the efficacy of endoscopic transnasal orbital decompression.
- To assess outcomes including proptosis reduction, intraocular pressure changes, and visual acuity.
- To report on surgical complications and cosmetic results.
Main Methods:
- Retrospective chart review of 25 patients (42 orbits) undergoing the procedure between 1996 and 2010.
- Preoperative and postoperative assessments included visual acuity, exophthalmometry, tonometry, and evaluation of exposure keratitis and diplopia.
- Outcomes measured by proptosis reduction, intraocular pressure reduction, and visual acuity improvement.
Main Results:
- Significant reduction in proptosis (mean 1.93-2.07 mm) and intraocular pressure (mean 4.40-4.38 mmHg) observed at 1 and 3 months postoperatively (p < 0.01).
- Visual acuity improved significantly, from 0.45 preoperatively to 0.66 and 0.70 at 1 and 3 months postoperatively.
- Postoperative relief of exposure keratitis was noted, with only one instance of cerebrospinal fluid leak as a complication.
Conclusions:
- Endoscopic transnasal orbital decompression is an effective treatment for dysthyroid orbitopathy.
- The procedure yields statistically significant improvements in proptosis, intraocular pressure, and visual acuity.
- It offers benefits in relieving exposure keratitis with favorable cosmetic results and a low complication rate.
