Maalouf T, Vedrine P O, Coffinet L, George J L
Oculoplastic Department, Ophtalmologie B, CHU Nancy, France.
Orbit. 2008;27(3):169-73. doi: 10.1080/01676830701523905.
The aim of this work was to detect and study mid-term rhinosinusal complications arising after bony orbital decompression via the inferior palpebral approach in patients with Graves' ophthalmopathy.
This retrospective study considered 48 patients treated for proptosis from 1999 to 2001 who underwent bony orbital decompression via the inferior palpebral approach. Nineteen (19) of these patients agreed to participate further by consenting to follow-up examinations performed specifically for the purpose of this study, which consisted of ophthalmologic (visual acuity, proptosis) and ENT (nasal dysfunction, rhinoscopy) examinations.
Mean mid-term postoperative follow-up of the 19 patients was 43.5 months (+/-12 months). Predominant rhinosinusal signs (rhinorrhea, altered sense of smell, nasal obstruction) were observed in 20% of this group (4 patients) without any unfavorable effect on daily life. Fiber-optic rhinoscopy disclosed mucosal secretions and edema in 5% (one patient).
Mid-term complications of bony orbital decompression via an inferomedial approach are relatively rare. Late postoperative sinusitis has not been reported. Signs of minor nasal dysfunction may occur but would have little impact on quality of life.
本研究旨在检测和研究格雷夫斯眼病患者经下睑入路行眼眶减压术后中期的鼻窦并发症。
本回顾性研究纳入了1999年至2001年间因眼球突出接受治疗并经下睑入路行眼眶减压术的48例患者。其中19例患者同意进一步参与本研究，同意接受专门为此研究目的进行的随访检查，包括眼科（视力、眼球突出度）和耳鼻喉科（鼻功能障碍、鼻内镜检查）检查。
19例患者术后中期平均随访时间为43.5个月（±12个月）。该组20%（4例）患者出现主要的鼻窦症状（鼻漏、嗅觉改变、鼻塞），但对日常生活无任何不利影响。纤维鼻内镜检查发现5%（1例）患者有黏膜分泌物和水肿。
经眶内下入路眼眶减压术的中期并发症相对少见。尚未报道术后晚期鼻窦炎。可能会出现轻微鼻功能障碍的症状，但对生活质量影响不大。
