Endoscopic and Transconjunctival Orbital Decompression for Thyroid-Related Orbital Apex Compression
Objective To evaluate the efficacy and safety of a combined endoscopic and transconjunctival orbital decompression in patients with thyroid‐related orbitopathy with orbital apex compression. Study Design Retrospective review. Methods A sequential series of patients with thyroid‐related orbitopathy p...
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| Veröffentlicht in: | The Laryngoscope 2003-03, Vol.113 (3), p.508-513 |
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| creator | Schaefer, Steven D. Soliemanzadeh, Peyman Della Rocca, David A. Yoo, Gu-Pei Maher, Elizabeth A. Milite, James P. Della Rocca, Robert C. |
| description | Objective To evaluate the efficacy and safety of a combined endoscopic and transconjunctival orbital decompression in patients with thyroid‐related orbitopathy with orbital apex compression.
Study Design Retrospective review.
Methods A sequential series of patients with thyroid‐related orbitopathy presenting with orbital apex compressive myopathy with and without optic neuropathy who were undergoing combined endoscopic and transconjunctival decompression by the same surgeons from 1992 to 2001 was reviewed. Patients were regularly evaluated preoperatively and postoperatively over a 3‐ to 55‐month period to record the effects of this approach on visual acuity, Hertel exophthalmometry, and diplopia. Complications and secondary ophthalmological procedures were reviewed.
Results Between 1992 and 2001, 72 combined endoscopic and transconjunctival decompressions were performed on 41 patients with orbital apex compression. Visual acuity improved in 89.3% of the patients with compressive optic neuropathy (P |
| doi_str_mv | 10.1097/00005537-200303000-00021 |
| format | Article |
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Study Design Retrospective review.
Methods A sequential series of patients with thyroid‐related orbitopathy presenting with orbital apex compressive myopathy with and without optic neuropathy who were undergoing combined endoscopic and transconjunctival decompression by the same surgeons from 1992 to 2001 was reviewed. Patients were regularly evaluated preoperatively and postoperatively over a 3‐ to 55‐month period to record the effects of this approach on visual acuity, Hertel exophthalmometry, and diplopia. Complications and secondary ophthalmological procedures were reviewed.
Results Between 1992 and 2001, 72 combined endoscopic and transconjunctival decompressions were performed on 41 patients with orbital apex compression. Visual acuity improved in 89.3% of the patients with compressive optic neuropathy (P <.0005) and in 34.1% of those without neuropathy. Proptosis was reduced by 3.65 mm, on average. There was one case of transient intraoperative cerebrospinal fluid extravasation at the site of the optic nerve decompression, and one patient developed epistaxis.
Conclusions The study supports the treatment of thyroid‐related orbital apex compression with and without compressive optic neuropathy by a combined transconjunctival and endoscopic approach. This approach offers short hospital stays, excellent visual recovery, and minimal complications in patients with thyroid‐related orbital apex compressive myopathy and related compressive optic neuropathy. The beneficial effects observed in the patients with visual loss continued to improve over time and were significant (P <.001).</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1097/00005537-200303000-00021</identifier><identifier>PMID: 12616205</identifier><identifier>CODEN: LARYA8</identifier><language>eng</language><publisher>Hoboken, NJ: John Wiley & Sons, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; compressive optic neuropathy ; Conjunctiva - surgery ; Decompression, Surgical - methods ; Diplopia - etiology ; Diplopia - surgery ; Endoscopy - methods ; Exophthalmos - etiology ; Exophthalmos - surgery ; Female ; Graves Disease - complications ; Graves Disease - surgery ; Humans ; Male ; Medical sciences ; Middle Aged ; Nerve Compression Syndromes - complications ; Nerve Compression Syndromes - surgery ; Ophthalmology ; Optic Nerve Diseases - complications ; Optic Nerve Diseases - surgery ; Orbit - surgery ; Orbit diseases ; orbital apex compressive myopathy ; orbital decompression ; Postoperative Care ; Preoperative Care ; Prospective Studies ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the eye and orbit ; Thyroid-related orbitopathy ; Visual Acuity - physiology</subject><ispartof>The Laryngoscope, 2003-03, Vol.113 (3), p.508-513</ispartof><rights>Copyright © 2003 The Triological Society</rights><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4401-254e8d1dd169699a25fdea33c8d1fcb06fafa42846ddb089c61bd5b8044525c73</citedby><cites>FETCH-LOGICAL-c4401-254e8d1dd169699a25fdea33c8d1fcb06fafa42846ddb089c61bd5b8044525c73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1097%2F00005537-200303000-00021$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1097%2F00005537-200303000-00021$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14600747$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12616205$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schaefer, Steven D.</creatorcontrib><creatorcontrib>Soliemanzadeh, Peyman</creatorcontrib><creatorcontrib>Della Rocca, David A.</creatorcontrib><creatorcontrib>Yoo, Gu-Pei</creatorcontrib><creatorcontrib>Maher, Elizabeth A.</creatorcontrib><creatorcontrib>Milite, James P.</creatorcontrib><creatorcontrib>Della Rocca, Robert C.</creatorcontrib><title>Endoscopic and Transconjunctival Orbital Decompression for Thyroid-Related Orbital Apex Compression</title><title>The Laryngoscope</title><addtitle>The Laryngoscope</addtitle><description>Objective To evaluate the efficacy and safety of a combined endoscopic and transconjunctival orbital decompression in patients with thyroid‐related orbitopathy with orbital apex compression.
Study Design Retrospective review.
Methods A sequential series of patients with thyroid‐related orbitopathy presenting with orbital apex compressive myopathy with and without optic neuropathy who were undergoing combined endoscopic and transconjunctival decompression by the same surgeons from 1992 to 2001 was reviewed. Patients were regularly evaluated preoperatively and postoperatively over a 3‐ to 55‐month period to record the effects of this approach on visual acuity, Hertel exophthalmometry, and diplopia. Complications and secondary ophthalmological procedures were reviewed.
Results Between 1992 and 2001, 72 combined endoscopic and transconjunctival decompressions were performed on 41 patients with orbital apex compression. Visual acuity improved in 89.3% of the patients with compressive optic neuropathy (P <.0005) and in 34.1% of those without neuropathy. Proptosis was reduced by 3.65 mm, on average. There was one case of transient intraoperative cerebrospinal fluid extravasation at the site of the optic nerve decompression, and one patient developed epistaxis.
Conclusions The study supports the treatment of thyroid‐related orbital apex compression with and without compressive optic neuropathy by a combined transconjunctival and endoscopic approach. This approach offers short hospital stays, excellent visual recovery, and minimal complications in patients with thyroid‐related orbital apex compressive myopathy and related compressive optic neuropathy. The beneficial effects observed in the patients with visual loss continued to improve over time and were significant (P <.001).</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>compressive optic neuropathy</subject><subject>Conjunctiva - surgery</subject><subject>Decompression, Surgical - methods</subject><subject>Diplopia - etiology</subject><subject>Diplopia - surgery</subject><subject>Endoscopy - methods</subject><subject>Exophthalmos - etiology</subject><subject>Exophthalmos - surgery</subject><subject>Female</subject><subject>Graves Disease - complications</subject><subject>Graves Disease - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nerve Compression Syndromes - complications</subject><subject>Nerve Compression Syndromes - surgery</subject><subject>Ophthalmology</subject><subject>Optic Nerve Diseases - complications</subject><subject>Optic Nerve Diseases - surgery</subject><subject>Orbit - surgery</subject><subject>Orbit diseases</subject><subject>orbital apex compressive myopathy</subject><subject>orbital decompression</subject><subject>Postoperative Care</subject><subject>Preoperative Care</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the eye and orbit</subject><subject>Thyroid-related orbitopathy</subject><subject>Visual Acuity - physiology</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkFtvEzEQhS0EoqHwF9C-wJthfN31Y5RepagVVRDwZHltr3DZrBd7A82_r9uE5BVb1sijb84cHYQqAp8IqPozlCMEqzEFYOUC4PIoeYFmRDCCuVLiJZqVFsONoN9P0Juc7wFIzQS8RieESiIpiBmy54OL2cYx2MoMrlolM5TvcL8Z7BT-mL66TW2YSj3zNq7H5HMOcai6mKrVz22KweE735vJuwM5H_1DtTjCb9GrzvTZv9vXU_T14ny1uMLL28vrxXyJLedAMBXcN444R6SSShkqOucNY7Y0O9uC7ExnOG24dK6FRllJWifaBjgXVNianaKPO90xxd8bnye9Dtn6vjeDj5usawayASUK2OxAm2LOyXd6TGFt0lYT0E8B638B60PA-jngMvp-v2PTrr07Du4TLcCHPWCyNX1X8rQhHzkuAWr-ZPZsx_0Nvd_-twG9nN_9EIITUrrPfvBOJuTJPxxkTPqlZc1qob_dXOovNxfySomFJuwR82WlvA</recordid><startdate>200303</startdate><enddate>200303</enddate><creator>Schaefer, Steven D.</creator><creator>Soliemanzadeh, Peyman</creator><creator>Della Rocca, David A.</creator><creator>Yoo, Gu-Pei</creator><creator>Maher, Elizabeth A.</creator><creator>Milite, James P.</creator><creator>Della Rocca, Robert C.</creator><general>John Wiley & Sons, Inc</general><general>Wiley-Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>8BM</scope></search><sort><creationdate>200303</creationdate><title>Endoscopic and Transconjunctival Orbital Decompression for Thyroid-Related Orbital Apex Compression</title><author>Schaefer, Steven D. ; Soliemanzadeh, Peyman ; Della Rocca, David A. ; Yoo, Gu-Pei ; Maher, Elizabeth A. ; Milite, James P. ; Della Rocca, Robert C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4401-254e8d1dd169699a25fdea33c8d1fcb06fafa42846ddb089c61bd5b8044525c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>compressive optic neuropathy</topic><topic>Conjunctiva - surgery</topic><topic>Decompression, Surgical - methods</topic><topic>Diplopia - etiology</topic><topic>Diplopia - surgery</topic><topic>Endoscopy - methods</topic><topic>Exophthalmos - etiology</topic><topic>Exophthalmos - surgery</topic><topic>Female</topic><topic>Graves Disease - complications</topic><topic>Graves Disease - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nerve Compression Syndromes - complications</topic><topic>Nerve Compression Syndromes - surgery</topic><topic>Ophthalmology</topic><topic>Optic Nerve Diseases - complications</topic><topic>Optic Nerve Diseases - surgery</topic><topic>Orbit - surgery</topic><topic>Orbit diseases</topic><topic>orbital apex compressive myopathy</topic><topic>orbital decompression</topic><topic>Postoperative Care</topic><topic>Preoperative Care</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the eye and orbit</topic><topic>Thyroid-related orbitopathy</topic><topic>Visual Acuity - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schaefer, Steven D.</creatorcontrib><creatorcontrib>Soliemanzadeh, Peyman</creatorcontrib><creatorcontrib>Della Rocca, David A.</creatorcontrib><creatorcontrib>Yoo, Gu-Pei</creatorcontrib><creatorcontrib>Maher, Elizabeth A.</creatorcontrib><creatorcontrib>Milite, James P.</creatorcontrib><creatorcontrib>Della Rocca, Robert C.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>ComDisDome</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schaefer, Steven D.</au><au>Soliemanzadeh, Peyman</au><au>Della Rocca, David A.</au><au>Yoo, Gu-Pei</au><au>Maher, Elizabeth A.</au><au>Milite, James P.</au><au>Della Rocca, Robert C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endoscopic and Transconjunctival Orbital Decompression for Thyroid-Related Orbital Apex Compression</atitle><jtitle>The Laryngoscope</jtitle><addtitle>The Laryngoscope</addtitle><date>2003-03</date><risdate>2003</risdate><volume>113</volume><issue>3</issue><spage>508</spage><epage>513</epage><pages>508-513</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><coden>LARYA8</coden><abstract>Objective To evaluate the efficacy and safety of a combined endoscopic and transconjunctival orbital decompression in patients with thyroid‐related orbitopathy with orbital apex compression.
Study Design Retrospective review.
Methods A sequential series of patients with thyroid‐related orbitopathy presenting with orbital apex compressive myopathy with and without optic neuropathy who were undergoing combined endoscopic and transconjunctival decompression by the same surgeons from 1992 to 2001 was reviewed. Patients were regularly evaluated preoperatively and postoperatively over a 3‐ to 55‐month period to record the effects of this approach on visual acuity, Hertel exophthalmometry, and diplopia. Complications and secondary ophthalmological procedures were reviewed.
Results Between 1992 and 2001, 72 combined endoscopic and transconjunctival decompressions were performed on 41 patients with orbital apex compression. Visual acuity improved in 89.3% of the patients with compressive optic neuropathy (P <.0005) and in 34.1% of those without neuropathy. Proptosis was reduced by 3.65 mm, on average. There was one case of transient intraoperative cerebrospinal fluid extravasation at the site of the optic nerve decompression, and one patient developed epistaxis.
Conclusions The study supports the treatment of thyroid‐related orbital apex compression with and without compressive optic neuropathy by a combined transconjunctival and endoscopic approach. This approach offers short hospital stays, excellent visual recovery, and minimal complications in patients with thyroid‐related orbital apex compressive myopathy and related compressive optic neuropathy. The beneficial effects observed in the patients with visual loss continued to improve over time and were significant (P <.001).</abstract><cop>Hoboken, NJ</cop><pub>John Wiley & Sons, Inc</pub><pmid>12616205</pmid><doi>10.1097/00005537-200303000-00021</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences compressive optic neuropathy Conjunctiva - surgery Decompression, Surgical - methods Diplopia - etiology Diplopia - surgery Endoscopy - methods Exophthalmos - etiology Exophthalmos - surgery Female Graves Disease - complications Graves Disease - surgery Humans Male Medical sciences Middle Aged Nerve Compression Syndromes - complications Nerve Compression Syndromes - surgery Ophthalmology Optic Nerve Diseases - complications Optic Nerve Diseases - surgery Orbit - surgery Orbit diseases orbital apex compressive myopathy orbital decompression Postoperative Care Preoperative Care Prospective Studies Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the eye and orbit Thyroid-related orbitopathy Visual Acuity - physiology |
| title | Endoscopic and Transconjunctival Orbital Decompression for Thyroid-Related Orbital Apex Compression |
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