Endoscopic and transcaruncular medial wall decompression in unilateral graves’ orbitopathy: a multicenter randomized study

Autor: Mahmoud A. El-Samkary, Hesham A. El-Sersy
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: The Egyptian Journal of Otolaryngology, Vol 33, Iss 3, Pp 573-578 (2017)
Druh dokumentu: article
ISSN: 1012-5574
2090-8539
DOI: 10.4103/ejo.ejo_27_17
Popis: Abstract Background Thyroid eye disease is the most common orbital inflammatory disorder causing unilateral or bilateral proptosis in an adult. Infiltrative orbitopathy thyroid disease characterized by the deposition of immune complexes and inflammatory cells with subsequent fibrosis can severely affect vision and damage the optic nerve. In this study, we compare the safety and efficacy of transcaruncular versus endoscopic orbital decompression in the management of patients with unilateral Graves’ orbitopathy. Patients and methods This is a retrospective comparative, center-based randomization which included 36 eyes of 36 different patients with Graves’ orbitopathy and axial proptosis ranging between 20 and 26 mm. Complete ophthalmic examination included visual acuity, color vision, intraocular pressure, fundus examination and visual field assessment. Proptosis was measured by Hertel exophthalmometry and computed tomography orbit for all the cases preoperatively and 1.6 months postoperatively. There were follow-ups at day 1 postoperative, and at 1, 3, 6 months. All patients were photographed by the same camera. Patients were divided and were randomized on center based, distributed into two groups: the endoscopic group (18 eyes) were operated on through nasal endoscopic approach and the transcaruncular group (18 eyes) were operated on through the transcaruncular approach. Result There was significant reduction in proptosis in each group after surgery (P
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