Suresh Rishi, Soparkar Charles N, Alford Eugene L
Texas A&M College of Medicine Bryan Texas USA.
Houston Methodist Institute for Reconstructive Surgery Houston Texas USA.
Laryngoscope Investig Otolaryngol. 2021 Jan 29;6(1):71-76. doi: 10.1002/lio2.531. eCollection 2021 Feb.
Characterize sinonasal complications associated with endoscopic orbital decompression for thyroid eye disease (TED).
Retrospective analysis of patients who underwent endoscopic orbital decompression at Houston Methodist Hospital by two otolaryngologists and one ophthalmologist between May 2016 and February 2020 for TED. Patient ethnicity, age, laterality, operative approach (middle turbinectomy vs middle turbinate sparing), and history of prior sinusitis were collected.
One hundred and forty-five orbital decompressions met the inclusion criteria. Postoperative obstructive sinusitis where herniated orbital fat caused obstruction of the sinus ostium occurred in 5.5% of operations. Patients who had a prior history of sinusitis were more likely to develop postoperative obstructive sinusitis ( = .02). The middle turbinectomy approach was more likely to show a reduced incidence of postoperative sinusitis ( = .014).
Given the increased difficulty of managing sinonasal complications in the context of a decompressed orbit, efforts should be made to identify factors that might reduce the incidence of postoperative endonasal complications. The current study suggests that resection of the middle turbinate may allow for increased space for orbital fat herniation and lead to a decreased incidence of postoperative obstructive sinusitis.
IV.
描述与甲状腺眼病（TED）内镜下眼眶减压相关的鼻窦并发症。
回顾性分析2016年5月至2020年2月期间在休斯顿卫理公会医院由两名耳鼻喉科医生和一名眼科医生为TED患者实施内镜下眼眶减压的情况。收集患者的种族、年龄、患侧、手术方式（中鼻甲切除术与保留中鼻甲）以及既往鼻窦炎病史。
145例眼眶减压手术符合纳入标准。5.5%的手术出现术后阻塞性鼻窦炎，即疝出的眶脂肪导致鼻窦口阻塞。有鼻窦炎病史的患者更易发生术后阻塞性鼻窦炎（P = 0.02）。中鼻甲切除术式更有可能降低术后鼻窦炎的发生率（P = 0.014）。
鉴于在眼眶减压情况下处理鼻窦并发症的难度增加，应努力确定可能降低术后鼻内并发症发生率的因素。当前研究表明，切除中鼻甲可能为眶脂肪疝出提供更多空间，并降低术后阻塞性鼻窦炎的发生率。
IV级。
