title: Image-guided endoscopic orbital decompression for Graves' orbitopathy.
abstract: OBJECTIVE
  We studied the efficacy and safety of image-guided balanced orbital decompression for Graves' orbitopathy.
  
  
  METHODS
  The data of 24 patients (45 orbits) were reviewed for demographics, ophthalmologic outcomes, and complications in regard to image-guided (18 orbits) versus non-image-guided surgery (27 orbits).
  
  
  RESULTS
  Overall, all patients had a reduction in proptosis (mean reduction, 6.2 mm in proptosis) as measured by Hertel exophthalmometry. There was improvement in the visual acuity of all 12 orbits with preoperative acuity of 20/40 or worse and either complete resolution (38%) or improvement (62%) in the 16 orbits with optic neuropathy. These measures reached statistical significance. Despite subjective improvement in surgeon confidence, the use of image guidance did not result in a statistically significant difference in postoperative ophthalmologic outcomes. Medical and sinonasal complications were experienced by 11.1% and 18.5% of patients who underwent image-guided and non-image-guided orbital decompression, respectively.
  
  
  CONCLUSIONS
  Image guidance may be a useful adjunct to balanced orbital decompression for Graves' orbitopathy, but it was not associated with a statistically significant improvement in outcomes in this study.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, New York Presbyterian Hospital-Columbia University College of Physicians and Surgeons, New York, New York, USA.
authors.forename: Marika R
authors.initials: MR
authors.lastname: Dubin
authors.forename: Abtin
authors.initials: A
authors.lastname: Tabaee
authors.forename: Jennifer T
authors.initials: JT
authors.lastname: Scruggs
authors.forename: Michael
authors.initials: M
authors.lastname: Kazim
authors.forename: Lanny Garth
authors.initials: LG
authors.lastname: Close
mesh_terms: D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D049970:Graves Ophthalmopathy / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome; D014792:Visual Acuity