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Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
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Supraorbital Neuralgia Associated With Thyroid Eye Disease
J Randall Patrinely1, Kristy L Hamilton2, Robert B Parke2
1Vanderbilt University School of Medicine, Nashville, Tennessee.
Ophthalmic Plastic and Reconstructive Surgery
|July 4, 2020
Summary
Supraorbital neuralgia (SON) is an underreported pain associated with thyroid eye disease (TED). Diagnosing and managing SON can lead to better outcomes, including reduced TED reactivation.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Thyroid eye disease (TED) can cause various symptoms, including orbital pain.
- Supraorbital neuralgia (SON) is a distinct type of facial pain that may be associated with TED.
Purpose of the Study:
- To investigate the relationship between TED and SON.
- To establish diagnostic and management strategies for TED-associated SON.
Main Methods:
- Retrospective analysis of 1,126 patients with TED.
- Assessment of TED activity and severity using established grading systems.
- Identification of periorbital pain subtypes and confirmation of SON via supraorbital nerve blocks.
Main Results:
- 8% of TED patients reported debilitating pain suggestive of SON.
- Supraorbital nerve blocks confirmed SON in 91 patients, leading to complete pain resolution.
- Patients with SON were more likely to undergo orbital decompression (97% vs. 48%) and experience TED reactivation (8% vs. 2%).
Conclusions:
- SON is a significant, previously underreported complication of TED.
- While not directly correlated with TED severity, SON presence indicates a higher risk of complications and disease activity.
- Effective diagnosis and management of SON are crucial for improving patient outcomes in TED.
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