van der Wal K G, de Visscher J G, Boukes R J, Smeding B
Department of Oral and Maxillofacial Surgery, Medisch Centrum Leeuwarden, The Netherlands.
Int J Oral Maxillofac Surg. 2001 Aug;30(4):254-8. doi: 10.1054/ijom.2001.0105.
Surgery has a definite place in the treatment of the exophthalmos in Graves orbitopathy. Thirty-two patients with Graves orbitopathy were operated on. Twenty patients received a three-wall orbital decompression. Five patients received a two-wall orbital decompression with lipectomy and seven patients underwent a two-wall orbital decompression combined with an advancement osteotomy of the supra-, lateral- and infra-orbital rim and a lipectomy. In cases with Hertel values less than 25 mm, the two-wall orbital decompression with removal of orbital fat. and in cases with Hertel values more than 25 mm, the two-wall orbital decompression with lipectomy and an advancement osteostomy of the supra-, lateral- and infraorbital rim is the treatment of choice.
手术在格雷夫斯眼眶病突眼治疗中具有明确地位。对32例格雷夫斯眼眶病患者进行了手术。20例患者接受了三壁眶减压术。5例患者接受了眶壁切除术的两壁眶减压术，7例患者接受了两壁眶减压术，同时进行眶上、眶外侧和眶下缘的截骨前移术及眶壁切除术。对于赫特尔值小于25mm的病例，采用两壁眶减压术并去除眶脂肪；对于赫特尔值大于25mm的病例，采用两壁眶减压术并进行眶壁切除术及眶上、眶外侧和眶下缘的截骨前移术是首选治疗方法。
