gms | German Medical Science

76th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

04.05. - 08.05.2005, Erfurt

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Long-term results after endonasal and combined endonasal/transfacial orbital decompression in Graves ophthalmopathy

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  • corresponding author Ilias Emmanouil - Department of Oto-Rhino-Laryngology, Klinikum Hannover Nordstadt, Hannover
  • B. Wiechens - Department of Ophthalmology, Klinikum Hannover Nordstadt, Hannover
  • T. Schloimann - Department of Ophthalmology, Klinikum Hannover Nordstadt, Hannover
  • H. J. Welkoborsky - Department of Oto-Rhino-Laryngology, Klinikum Hannover Nordstadt, Hannover

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno407

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2005/05hno196.shtml

Published: September 22, 2005

© 2005 Emmanouil et al.
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Outline

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Graves ophthalmopathy (GO) is an autoimmune inflammatory disorder that is characterized by an inflammatory infiltration of the extraocular muscles and the orbital fat. Although conservative therapy is used in this disease, it often shows a progress so that orbital decompression (OD) is indicated. Until now, only a few studies on long-term results after OD exist.

We report about long-term results of 22 patients (15 female, 7 male, mean age 49 y. mean preoperative duration of disease 4,1 y.). Patients symptoms included exophthalmos, motility disturbances, decreased visual acuity and corneal exposure. Preoperative treatment in all patients included steroids, and 11 patients were treated with radiotherapy.

11 patients (20 orbits) were treated by endonasal and 11 patients (21 orbits) were treated by combined endonasal/transfacial 2-wall-decompression. Long-term follow-up data (12-78 months postoperative, median 42 months) was obtained: age, sex, symptoms, preoperative treatment, visual acuity, Hertel measurements, tensio, diplopia history and eye motility. All patients showed a complete palpebral fissure closing and an improvement in vision postoperatively. Four patients had new-onset of diplopia. No revision decompression surgery was necessary, but 2 patients underwent strabism surgery due to persistent diplopia.

OD in the treatment of GO by endonasal or combined endonasal/transfacial approach in patients without improvement after conservative treatment is an long-term efficacious operation without major complications.