title: Orbital decompression in graves' ophthalmopathy by medial and lateral wall removal.
abstract: OBJECTIVE
  The objective of this study is to describe a technique for balanced orbital decompression and to analyze the results.
  
  
  METHODS
  We conducted a retrospective study of 140 patients (276 orbits). Orbital decompression was carried out by removal of the medial orbital wall by ethmoidectomy and complete removal of the lateral wall by bringing out the entire sphenoid wing together with part of the zygomatic bone down to the inferior orbital fissure.
  
  
  RESULTS
  One hundred thirty-six patients underwent bilateral decompression, 4 patients underwent monolateral decompression. Proptosis was reduced on average by 5.3 mm; 28 (20%) patients showed onset or worsening of diplopia.
  
  
  CONCLUSIONS
  Medial and lateral approach allows a balanced orbital decompression. As some patients may present different degrees of proptosis and visual impairment, we stress the importance of carefully weighing the preoperative conditions of the individual patient when choosing the surgical approach.
authors.affiliation: Department of Neuroscience, Ia ENT division, Pisa, Italy. s.sellari@med.unipi.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Sellari-Franceschini
authors.forename: Stefano
authors.initials: S
authors.lastname: Berrettini
authors.forename: Amelia
authors.initials: A
authors.lastname: Santoro
authors.forename: Marco
authors.initials: M
authors.lastname: Nardi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Mazzeo
authors.forename: Luigi
authors.initials: L
authors.lastname: Bartalena
authors.forename: Barbara
authors.initials: B
authors.lastname: Mazzi
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Tanda
authors.forename: Claudio
authors.initials: C
authors.lastname: Marcocci
authors.forename: Aldo
authors.initials: A
authors.lastname: Pinchera
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000379:methods*; D005005:Ethmoid Sinus / Q000601:surgery*; D005094:Exophthalmos / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000379:methods; D009915:Orbit / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome