[Endoscopic transnasal orbital balanced decompression technique for severe Graves' orbitopathy].

OBJECTIVE

To determine the efficacy of endoscopic transnasal orbital balanced decompression technique for the treatment of severe Graves' orbitopathy.

METHODS

Six cases (12 eyes) of severe Graves'orbitopathy were included in this study. All patients were undergone endoscopic transnasal orbital balanced decompression technique (orbital inner and lower wall decompression+ lateral orbital decompression) for severe Graves'orbitopathy and serious affecting visual function or appearance.

RESULTS

The follow-up ranged from 12 months to 2 years and 4 months. Postoperatively, the visual acuity markly improved from 0.23 ± 0.08 to 0.48 ± 0.13 (t=-5.749, P<0.001). Proptosis measured by exophthalmoter distictly reduced from (22.08 ± 1.08) mm to (15.67 ± 1.44) mm (t=17.924, P< 0.001). The palpebral fissures obviously reduced from (12.03 ± 0.91) mm to (8.62 ± 0.75) mm (t=9.600, P< 0.001), and orbital volume evidently increased from (26.84 ± 0.62) cm³ to (31.56 ± 1.10) cm³ (t=-16.567, P<0.001). Compared with the preoperative result, the orbital pressure was significantly decreased after operation (t=-6.759 (Y=100 g), t=-11.850 (Y=200 g), t=-6.189 (Y=300 g), P<0.001). Diplopia was appeared in 3 cases, and disappeared 3 to 5 months after surgery.

CONCLUSION

Endoscopic transnasal orbital balanced decompression technique is effective for the treatment of severe Graves'orbitopathy.