Endoscopic Orbital Decompression for Dysthyroid Orbitopathy

Koh, Seok Joo; Dhong, Hun Jong

Abstract

Since 1957, when Walsh and Ogura introduced transantral orbital decompression, various surgical approaches have been introduced for the treatment of dysthyroid orbitopathy. With the development of endoscopic sinus surgery, orbital decompression can now be approached transnasally by endoscope alone. We reviewed the medical records of 10 patients who had received endoscopic orbital decompression. Of the 10 patients, four eyes from three patients were managed for decreased visual acuity, while 13 eyes from seven patients were managed for exophthalmos. Three patients who had initially complained of decreased vision demonstrated eventual improvement. An initial mean proptosis of 19.3 mm decreased to 16.5 mm. Six eyes with abnormal color vision were resolved after the decompression. Four patients with diplopia complained of continued diplopia after the decompression and were managed with extraocular muscle surgery or prism glasses. Compared to the conventional transantral approach, endoscopic orbital decompression features less morbidity and comparable ophthalmic results.