Transnasal endoscopic orbital decompression: 15-year clinical experience in Southern Taiwan.
OBJECTIVE
To present the results and evaluate the efficacy of endoscopic transnasal orbital decompression for dysthyroid orbitopathy.


METHODS
Retrospective chart review of patients who underwent endoscopic transnasal orbital decompression from 1996 to 2010 in one institution. We included 42 orbits of 25 patients. Preoperative and postoperative examinations included visual acuity, Hertel exophthalmometry, tonometry, exposure keratitis, and diplopia. The measurements of outcome depend on proptosis reduction, intraocular pressure reduction, and visual acuity improvement of 42 orbits of 25 patients.


RESULTS
There were no surgical complications for the 42 orbital decompressions except one patient experienced cerebrospinal fluid leak during the operation. Mean proptosis reduction in all orbits was 1.93 ± 0.25 (mean ± standard deviation, p < 0.01) after 1 month postoperatively and 2.07 ± 0.29 (p < 0.01) after 3 months postoperatively. An average reduction of intraocular pressure was 4.40 ± 0.72 (p < 0.01) and 4.38 ± 0.80 (p < 0.01) respectively after 1 and 3 months postoperatively. Visual acuity increased from a preoperative average of 0.45 ± 0.34 to 0.66 ± 0.36 and 0.70 ± 0.35 after 1 and 3 months postoperatively. In addition, postoperative relief of exposure keratitis is also noted.


CONCLUSIONS
The transnasal orbital decompression procedure has statistically significant improvements in proptosis, intraocular pressure, and visual acuity. The procedure has obvious benefit in relieving exposure keratitis. Furthermore, there are favorable cosmetic results and rare complications.
Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, ROC; Department of Otolaryngology-Head and Neck Surgery, National Defense Medical Centre & Tri-Service General Hospital, Taipei, Taiwan.
Yun-Ying
YY
She
Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, ROC; Department of Otolaryngology-Head and Neck Surgery, National Defense Medical Centre & Tri-Service General Hospital, Taipei, Taiwan. Electronic address: ccchi@vghks.gov.tw.
Chao-Chuan
CC
Chi
Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, ROC; Department of Otolaryngology-Head and Neck Surgery, National Defense Medical Centre & Tri-Service General Hospital, Taipei, Taiwan.
Sau-Tung
ST
Chu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005544:Forecasting; D049970:Graves Ophthalmopathy / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009666:Nose; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D014792:Visual Acuity
Graves ophthalmopathy; diplopia; exophthalmos; keratitis; natural orifice transluminal endoscopic surgery