[Endoscopic transnasal orbital balanced decompression technique for severe Graves' orbitopathy]

Area of Science:

• Ophthalmology
• Endoscopic Surgery
• Endocrinology

Background:

• Graves' orbitopathy (GO) is a complex autoimmune condition affecting the eye socket.
• Severe cases of GO can lead to significant visual impairment and disfigurement.
• Surgical decompression is often necessary to alleviate intraorbital pressure and restore function.

Purpose of the Study:

• To evaluate the efficacy of the endoscopic transnasal orbital balanced decompression technique.
• To assess the impact of this technique on visual acuity, proptosis, and orbital volume in severe GO patients.

Main Methods:

• A study involving six patients (12 eyes) with severe Graves' orbitopathy.
• All patients underwent endoscopic transnasal orbital balanced decompression (combined inner, lower, and lateral wall decompression).
• The procedure aimed to improve visual function and appearance in patients with severe GO.

Main Results:

• Significant improvement in visual acuity (0.23 to 0.48) and marked reduction in proptosis (22.08 mm to 15.67 mm).
• Palpebral fissures reduced (12.03 mm to 8.62 mm), and orbital volume increased (26.84 cm³ to 31.56 cm³).
• Orbital pressure significantly decreased postoperatively; diplopia occurred in 3 cases but resolved within 3-5 months.

Conclusions:

• Endoscopic transnasal orbital balanced decompression is a highly effective treatment for severe Graves' orbitopathy.
• The technique offers substantial improvements in ocular function and aesthetics.
• It represents a valuable minimally invasive surgical option for managing complex GO cases.