Image-guided endoscopic orbital decompression for Graves' orbitopathy.

Abstract

OBJECTIVES:

We studied the efficacy and safety of image-guided balanced orbital decompression for Graves' orbitopathy.

METHODS:

The data of 24 patients (45 orbits) were reviewed for demographics, ophthalmologic outcomes, and complications in regard to image-guided (18 orbits) versus non-image-guided surgery (27 orbits).

RESULTS:

Overall, all patients had a reduction in proptosis (mean reduction, 6.2 mm in proptosis) as measured by Hertel exophthalmometry. There was improvement in the visual acuity of all 12 orbits with preoperative acuity of 20/40 or worse and either complete resolution (38%) or improvement (62%) in the 16 orbits with optic neuropathy. These measures reached statistical significance. Despite subjective improvement in surgeon confidence, the use of image guidance did not result in a statistically significant difference in postoperative ophthalmologic outcomes. Medical and sinonasal complications were experienced by 11.1% and 18.5% of patients who underwent image-guided and non-image-guided orbital decompression, respectively.

CONCLUSIONS:

Image guidance may be a useful adjunct to balanced orbital decompression for Graves' orbitopathy, but it was not associated with a statistically significant improvement in outcomes in this study.

• Authors: Marika R Dubin, Abtin Tabaee, Jennifer T Scruggs, Michael Kazim, Lanny Garth Close
• Journal: The Annals of otology, rhinology, and laryngology (Ann Otol Rhinol Laryngol) Vol. 117 Issue 3 Pg. 177-85 (Mar 2008) ISSN: 0003-4894 [Print] United States
• PMID: 18444477 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Aged
• Decompression, Surgical (methods)
• Endoscopy (methods)
• Female
• Graves Ophthalmopathy (surgery)
• Humans
• Male
• Middle Aged
• Optic Nerve Diseases (surgery)
• Postoperative Complications
• Retrospective Studies
• Surgery, Computer-Assisted
• Treatment Outcome
• Visual Acuity