Orbital Decompression in Dysthyroid Ophthalmopathy Using Combined Transantral and Transnasal Endoscopic Approach / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Dysthyroid ophthalmopathy is consider to be an autoimmune disorder and the disease is permanent in about 70% of the patients. Endoscopic intranasal approach for the decompression has been described by Kennedy in 1990. However a limitation of the approach is that decompression of the orbital floor lateral to the infraorbital nerve is not possible. So we modified caldwell- Luc's approach combined intranasal decompression by endoscopy. MATERIALS AND METHODS: We performed the orbital decompressions in 5 cases with the exophthalmos. When the inferior bony wall was removed, medial and lateral to the inferior orbital nerve were removed separately and bony ridge was created to protect the nerve. Upper one-third of the lateral wall was penetrated to make an space for herniation of orbital content in case of severe exphthalmos. RESULT: All of the cases were satisfied with the surgery and there has been no evidence of the recurrence so far. CONCLUSION: These combined techniques produce satisfactory results, especially in severe cases.