Orbital decompression in graves' ophthalmopathy by medial and lateral wall removal.
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.
Sellari-Franceschini
Stefano
S
Department of Neuroscience, Ia ENT division, Pisa, Italy. s.sellari@med.unipi.it
Berrettini
Stefano
S
Santoro
Amelia
A
Nardi
Marco
M
Mazzeo
Salvatore
S
Bartalena
Luigi
L
Mazzi
Barbara
B
Tanda
Maria Laura
ML
Marcocci
Claudio
C
Pinchera
Aldo
A
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