title: C-modified osteotomy for bilateral advancement of the orbital rim in Graves orbitopathy: a technical note.
abstract: The authors present a modification of the classical three-wall orbital decompression for the treatment of Graves' orbitopathy. It consists of two 'C' osteotomies for the bilateral projection of the superolateral, lateral and inferolateral orbital rims, associated with the removal of the lateral orbital walls. This technique is performed following a coronal approach. Ultrasound cutting instruments were used for the osteotomies. They avoided lesion of surrounding soft tissues, such as the duramater and the periorbital tissues. Stabilization of the advanced structure was achieved by interposition of autologous bone graft obtained from the outer cortex of the calvaria. An extreme advancement of the orbital rim with resolution of diplopia, ocular pain and eyelid incompetence was obtained. Using this procedure, a good functional and aesthetic outcome was achieved.
authors.affiliation: Department of Oral and Maxillofacial-Head and Neck Surgery, University Hospital La Princesa, Autonoma University, c/ Diego de León 62, 28006, Madrid, Spain. raulmaxilo@gmail.com
authors.forename: R
authors.initials: R
authors.lastname: González-García
authors.forename: J
authors.initials: J
authors.lastname: Sastre-Pérez
authors.forename: F J
authors.initials: FJ
authors.lastname: Rodríguez-Campo
authors.forename: L
authors.initials: L
authors.lastname: Naval-Gías
authors.forename: F
authors.initials: F
authors.lastname: Monje
mesh_terms: D000368:Aged; D019299:Decompression, Surgical / Q000379:methods; D049970:Graves Ophthalmopathy / Q000601:surgery*; D006801:Humans; D008297:Male; D009915:Orbit / Q000601:surgery*; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000295:instrumentation