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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

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Sinonasal complications associated with endoscopic orbital decompression.

Rishi Suresh¹, Charles N Soparkar², Eugene L Alford²

¹Texas A&M College of Medicine Bryan Texas USA.

Laryngoscope Investigative Otolaryngology

|February 22, 2021

Summary

Endoscopic orbital decompression for thyroid eye disease (TED) can cause obstructive sinusitis. A middle turbinectomy approach may reduce this complication, especially in patients with a history of sinusitis.

Keywords:

Graves' disease adult rhinology orbital decompression outcomes/cost effectiveness scholarly databases sinusitis statistics thyroid eye disease

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Area of Science:

Otolaryngology
Ophthalmology
Endocrinology

Background:

Thyroid eye disease (TED) often requires surgical intervention like orbital decompression.
Endoscopic orbital decompression is a common surgical approach for TED.
Sinonasal complications can arise post-decompression, impacting patient outcomes.

Purpose of the Study:

To characterize sinonasal complications following endoscopic orbital decompression for TED.
To identify risk factors associated with postoperative sinonasal complications.
To evaluate the impact of surgical approach on complication rates.

Main Methods:

Retrospective analysis of 145 patients undergoing endoscopic orbital decompression for TED.
Data collected included patient demographics, operative approach (middle turbinectomy vs. sparing), and history of sinusitis.
Statistical analysis was performed to identify significant associations.

Main Results:

Postoperative obstructive sinusitis occurred in 5.5% of cases, often due to herniated orbital fat.
A history of prior sinusitis was significantly associated with increased risk of postoperative sinusitis (P = .02).
The middle turbinectomy approach showed a reduced incidence of postoperative sinusitis (P = .014).

Conclusions:

Sinonasal complications, particularly obstructive sinusitis, are a concern after endoscopic orbital decompression for TED.
Identifying and mitigating factors that reduce these complications is crucial for improved patient management.
Resection of the middle turbinate may decrease the incidence of postoperative obstructive sinusitis by accommodating orbital fat herniation.