Orbital Decompression in Thyrotoxic Ophthalmopathy with Nasal Endoscope Assisted Orbital Decompression Technique.

Lee, Jun Ho; Kim, Hyo Hun; Kim, Yong Ha

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Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2003;30(5):659-663.
Published online September 1, 2003.

Orbital Decompression in Thyrotoxic Ophthalmopathy with Nasal Endoscope Assisted Orbital Decompression Technique.

Jun Ho Lee, Hyo Hun Kim, Yong Ha Kim

Department of Plastic & Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu, Korea. yhkim@med.yu.ac.kr

Abstract

Graves' exophthalmos occurs in 45% of thyrotoxic patients. When exophthalmos progresses rapidly and becomes the major concern in Graves' disease, it is termed exophthalmic and, if severe, malignant exophthalmos. These can cause functional and aesthetic problems such as exopthalmos, chemosis, cornea exposure, eyelid retraction, limited eyeball movement, diplopia, epiphora and gradual amblyopia. Medical and surgical treatments were required to correct Graves' exopthalmos and many surgical methods have been reported. These methods were developed to get maximal decompression effect minimizing complications such as inadequate orbital decompression, optic nerve injury, operative scar etc. Herein, the authors reported the correction of the Graves' exophthalmos using transnasal endoscopic assisted Tessier-Wolfe's three wall expansion technique with satisfactory result. This method can expect several advantages; first, the maximum decompression effect with guarantee of the visual operative field, second, prevention of in-flow of temporalis or brain parenchyme via movement of a single framework of bone segments, third, minimum of postoperative scar and intraoperative trauma with decrease of the incidence of the postoperative diplopia and paresthesia and rapid recovery period.

Keywords: Orbital decompression; Thyrotoxic ophthalmopathy

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