title: Endoscopic transnasal orbital decompression for thyrotoxic orbitopathy.
abstract: OBJECTIVE
  To evaluate the efficacy of endoscopic transnasal orbital decompression alone for thyrotoxic orbitopathy.
  
  
  METHODS
  Retrospective review of consecutive procedures.
  
  
  METHODS
  Tertiary referral otorhinolaryngology centre.
  
  
  METHODS
  Twenty-three eyes of 14 patients.
  
  
  METHODS
  Endoscopic transnasal orbital decompression.
  
  
  METHODS
  Proptosis reduction, intra-ocular pressure reduction, exposure keratitis reduction, visual acuity improvement, and complication rate.
  
  
  RESULTS
  There were no surgical complications for the 23 orbital decompressions. Proptosis reduction was achieved in 22 (96%) eyes. The mean proptosis reduction was 4.6 mm (median, 5.0 mm; range, 1.0-8.0 mm). The postoperative intra-ocular pressure decreased after surgical decompression in 20 (87%) eyes with a mean reduction of 11 mm Hg (median, 6 mm Hg; range, 1-35 mm Hg). Of the 15 eyes with incomplete closure of the eyelid before the operation, 11 (73%) had complete eyelid closure after surgical decompression. Of the other four eyes that had incomplete closure, the gaps were reduced. The visual acuity was improved for 16 (70%) eyes with a median improvement of 3 Snellen lines (range, 1-8 lines).
  
  
  CONCLUSIONS
  Endoscopic transnasal medio-inferior orbital wall decompression is a safe and adequate treatment for thyrotoxic orbitopathy with proptosis, exposure keratitis, and visual loss.
authors.affiliation: Division of Otorhinolaryngology, Department of Surgery, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong.
authors.forename: A P W
authors.initials: AP
authors.lastname: Yuen
authors.forename: K Y W
authors.initials: KY
authors.lastname: Kwan
authors.forename: E
authors.initials: E
authors.lastname: Chan
authors.forename: A W C
authors.initials: AW
authors.lastname: Kung
authors.forename: K S L
authors.initials: KS
authors.lastname: Lam
mesh_terms: D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D004172:Diplopia / Q000517:prevention & control; D004724:Endoscopy / Q000379:methods*; D005094:Exophthalmos / Q000601:surgery*; D005141:Eyelid Diseases / Q000517:prevention & control; D005260:Female; D006111:Graves Disease / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D007634:Keratitis / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000150:complications; D009900:Optic Nerve / Q000503:physiopathology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity