Mid-term rhinosinusal consequences of bony orbital decompression in Graves' disease: a retrospective study.
OBJECTIVE
The aim of this work was to detect and study mid-term rhinosinusal complications arising after bony orbital decompression via the inferior palpebral approach in patients with Graves' ophthalmopathy.


METHODS
This retrospective study considered 48 patients treated for proptosis from 1999 to 2001 who underwent bony orbital decompression via the inferior palpebral approach. Nineteen (19) of these patients agreed to participate further by consenting to follow-up examinations performed specifically for the purpose of this study, which consisted of ophthalmologic (visual acuity, proptosis) and ENT (nasal dysfunction, rhinoscopy) examinations.


RESULTS
Mean mid-term postoperative follow-up of the 19 patients was 43.5 months (+/-12 months). Predominant rhinosinusal signs (rhinorrhea, altered sense of smell, nasal obstruction) were observed in 20% of this group (4 patients) without any unfavorable effect on daily life. Fiber-optic rhinoscopy disclosed mucosal secretions and edema in 5% (one patient).


CONCLUSIONS
Mid-term complications of bony orbital decompression via an inferomedial approach are relatively rare. Late postoperative sinusitis has not been reported. Signs of minor nasal dysfunction may occur but would have little impact on quality of life.
Oculoplastic Department, Ophtalmologie B, CHU Nancy, France. t.maalouf@chu-nancy.fr
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Maalouf
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Vedrine
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Coffinet
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George
D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000379:methods; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000150:complications / Q000175:diagnosis; D049970:Graves Ophthalmopathy / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000453:epidemiology / Q000209:etiology; D000857:Olfaction Disorders / Q000453:epidemiology / Q000209:etiology; D009915:Orbit / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D014057:Tomography, X-Ray Computed