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稳定型甲状腺眼病患者经眶筛蝶窦径路减压术的疗效评估:系列病例 47 例。

Graded transantral orbital decompression outcomes in stable thyroid eye disease: a series of 47 orbits.

机构信息

Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.

Eyesthetica, Oculofacial and Cosmetic Surgery Associates, Los Angeles, California, USA.

出版信息

Orbit. 2021 Jun;40(3):215-221. doi: 10.1080/01676830.2020.1760313. Epub 2020 May 3.

DOI:10.1080/01676830.2020.1760313
PMID:32363975
Abstract

: To provide outcome data for transantral orbital decompression for functional and aesthetic rehabilitation for exophthalmos in stable thyroid eye disease (TED).: Retrospective, non-comparative chart review of consecutive TED patients who underwent primary-graded transantral orbital decompression for exophthalmos by a single surgeon (MAB) between 2005 and 2018. Additional inclusion criteria included follow-up >90 days and no prior orbital surgery. Outcome data collection included millimeters of proptosis reduction, postoperative complications, and patient satisfaction.: A total 30 patients (47 orbits) were included. Average reduction in proptosis: 2.8 mm (range 0-9 mm, median 2.5 mm). Post-operatively, new onset diplopia occurred in four patients, V2 numbness in 15 patients (17 orbits), and sinusitis in 2 patients (2 orbits). Phone surveys reached 9/30 patients (14 orbits): cosmetic improvement was reported in 14/14 orbits, relief of orbital ache reported in 10/10 orbits with pre-operative ache, relief of dry eye in 8/13 orbits with preoperative dry eye, and overall satisfaction score: 8.9/10 (range 4-10, median 10).: Graded transantral orbital decompression is a viable option for stable TED patients with orbital ache, exophthalmos, and exposure keratopathy, resulting in a high degree of functional and cosmetic satisfaction in our cohort.

摘要

目的

提供经蝶窦眶减压术治疗稳定期甲状腺眼病(TED)患者眼球突出症的功能和美学康复的结果数据。

方法

回顾性分析了 2005 年至 2018 年间,由一名外科医生(MAB)对连续的 TED 患者进行原发性经蝶窦眶减压术治疗眼球突出症的患者。另外的纳入标准包括随访时间>90 天且无先前的眼眶手术史。结果数据采集包括眼球突出度的毫米数减少、术后并发症和患者满意度。

结果

共纳入 30 例(47 只眼)患者。平均眼球突出度减少:2.8 毫米(范围 0-9 毫米,中位数 2.5 毫米)。术后有 4 例新发复视,15 例(17 只眼)出现 V2 麻木,2 例(2 只眼)出现鼻窦炎。通过电话调查了 30 例患者中的 9 例(14 只眼):14 只眼报告美容改善,10 只眼(术前有眼球突出症)报告眶痛缓解,8 只眼(术前有干眼症)报告干眼症缓解,总体满意度评分为 8.9/10(范围 4-10,中位数 10)。

结论

分级经蝶窦眶减压术是一种可行的选择,适用于有眶痛、眼球突出症和暴露性角膜炎的稳定期 TED 患者,在我们的队列中,这种手术具有高度的功能和美容满意度。

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