Department of Ophthalmology, Sussex Eye Hospital, Eastern Road, Brighton.
Department of Ears, Nose and Throat, Princess Royal Hospital, Haywards Heath, United Kingdom.
Ophthalmic Plast Reconstr Surg. 2019 Nov/Dec;35(6):590-593. doi: 10.1097/IOP.0000000000001406.
Orbital decompression is an established surgical treatment option for a range of orbital conditions. Traditionally, Ear, Nose and Throat surgeons have adopted the endoscopic route while ophthalmologists operate via an external approach. The authors report the outcomes of endonasal decompression performed by oculoplastic surgeons experienced in endonasal techniques.
This was a retrospective case series of patients who underwent endoscopic orbital decompression for proptosis secondary to thyroid eye disease across 2 hospital sites between January 2011 and July 2018. Inclusion criteria were patients who had endoscopic decompression for proptosis in inactive thyroid eye disease or active disease without dysthyroid optic neuropathy. Information collected includes patient demographics, diagnosis, surgical details, preoperative and postoperative clinical findings (including, visual acuity, color vision, exophthalmometry readings, palpebral aperture, intraocular pressure, ocular motility, diplopia, and visual field), complications, and further treatment.
There were 70 cases of endoscopic decompression. The majority of patients had endoscopic medial and posterior medial wall/floor decompression (44.3%; 31/70 cases). Visual acuity remained stable in 98.6% (69/70). There was an average reduction in proptosis of 3.5 ± 1.2 mm (standard deviation [SD]) in the endoscopic medial wall only group, 3.9 ± 0.9 mm (SD) in endoscopic medial wall and posterior medial portion of the floor group, and 7.6 ± 2.1 mm (SD) in the 3-wall decompression group. Motility improved in 11.4% (8/70) and worsened in 2.9% (2/70). There were no significant intraoperative or postoperative complications associated with endoscopic surgery.
Oculoplastic surgeons experienced in endonasal techniques can perform endoscopic orbital decompression with outcomes comparable to the literature.The authors report the outcomes of a series of endonasal orbital decompression carried out by oculoplastic surgeons.
眼眶减压术是治疗多种眼眶疾病的一种既定手术治疗选择。传统上，耳鼻喉科医生采用内窥镜入路，而眼科医生则采用外部入路。作者报告了在鼻内技术方面经验丰富的眼整形外科医生进行鼻内减压的结果。
这是一项回顾性病例系列研究，研究对象为 2011 年 1 月至 2018 年 7 月期间在 2 家医院接受内镜眼眶减压术治疗甲状腺眼病引起的眼球突出的患者。纳入标准为患有静止性甲状腺眼病或活动性甲状腺眼病但无甲状腺相关视神经病变的患者。收集的信息包括患者人口统计学资料、诊断、手术细节、术前和术后临床发现（包括视力、色觉、眼球突出度读数、睑裂、眼压、眼球运动、复视和视野）、并发症和进一步治疗。
共进行了 70 例内镜减压术。大多数患者行内镜内侧壁和后内侧壁/地板减压术（44.3%，31/70 例）。98.6%（69/70）的视力保持稳定。仅行内镜内侧壁减压术组平均眼球突出度降低 3.5±1.2mm（标准差[SD]），内镜内侧壁和地板后内侧部分减压术组降低 3.9±0.9mm（SD），3 壁减压术组降低 7.6±2.1mm（SD）。11.4%（8/70）的运动功能改善，2.9%（2/70）的运动功能恶化。内镜手术无明显术中或术后并发症。
在鼻内技术方面经验丰富的眼整形外科医生可以进行内镜眼眶减压术，其结果可与文献相媲美。作者报告了一系列由眼整形外科医生进行的鼻内眼眶减压术的结果。
