[Indication and technique of orbital enlargement in the treatment of endocrine ophthalmopathy].
Typical symptoms in endocrine ophthalmopathy are a result of an interstitial swelling of the ocular muscles and of the volume increase of the postbulbar fat and connective tissue. Clinically, we find a spectrum that reaches from infiltration of the eyelid and conjunctival tissue, exophthalmos, swelling of the muscles with diplopia, damage to the cornea till to involvement of the optic nerve with loss of vision. Regarding functional impairment of the optic nerve, orbital decompression represents an operative ultimate ratio. The surgical principle is based on the decompression within one or usually several orbital walls occasionally in combination with a sagittal enlargement of the eye socket by osteotomy and advancement of the orbital rims. As rule of thumb is considered: The reduction of the exophthalmos is proportional to the number of decompressed walls and amounts to 2-3 mm per decompressed orbital wall. A reduction of exophthalmos going beyond that can be obtained by advancement of the orbital rims.
Obwegeser
J A
JA
Abteilung für Mund-, Kiefer- und Gesichtschirurgie, Allgemeines Krankenhaus, Krankenhausstrasse 9, A-4020 Linz. joachim.obwegeser@akh.linz.at
Gattinger
B
B
D003228:Conjunctiva / Q000601:surgery; D005094:Exophthalmos / Q000601:surgery; D005143:Eyelids / Q000601:surgery; D006111:Graves Disease / Q000601:surgery*; D006801:Humans; D009801:Oculomotor Muscles / Q000601:surgery*; D009900:Optic Nerve / Q000601:surgery; D013514:Surgical Procedures, Operative / Q000379:methods*