title: Surgical complications in orbital decompression for Graves' orbitopathy.
abstract: The objective of this study is to analyse the complications of orbital decompression in Graves' orbitopathy. The clinical records of 946 patients who had been operated on with orbital decompression for Graves' orbitopathy were reviewed and the intra- and post-operative complications with minimum follow-up of six months were analysed. An extensive review of the literature was carried out to compare results. In the case-series reported here the most frequent complications were: wasting of the temporal region (100%) in patients operated on using a coronal approach; permanent hypoesthesia of V2 (13%) and V1 (8%) in patients operated on with an upper eyelid incision. In only one patient was a total monolateral lesion of V2 reported. The most severe complications consisted in reduction of visual acuity in 5 patients, and CSF leak with cerebral complications in 2 patients, who were operated on with a non-endoscopic endonasal approach. Three patients had intra-operative haemorrhages and 3 patients had post-operative haemorrhages requiring further surgical intervention. The incidence of symptomatic sinusitis/mucoceles was 0.75%. In conclusion, orbital decompression carried out with endoscopic endonasal technique and via transpalpebral accesses appears to be associated with a low incidence of complications. Knowledge of the causes of the possible complications in the different surgical approaches can definitely help to reduce their incidence.
authors.affiliation: First ENT Unit, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Sellari-Franceschini
authors.affiliation: First ENT Unit, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Dallan
authors.affiliation: First ENT Unit, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bajraktari
authors.affiliation: First ENT Unit, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Fiacchini
authors.affiliation: Unit of Ophthalmology, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Nardi
authors.affiliation: Unit of Endocrinology, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Rocchi
authors.affiliation: Unit of Endocrinology, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Marcocci
authors.affiliation: Unit of Endocrinology, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Marinò
authors.affiliation: First ENT Unit, Azienda Ospedaliero-Universitaria Pisana, University of Pisa, Italy.
authors.forename: A P
authors.initials: AP
authors.lastname: Casani
mesh_terms: D019299:Decompression, Surgical / Q000009:adverse effects*; D049970:Graves Ophthalmopathy / Q000601:surgery*; D006801:Humans; D009915:Orbit; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*
keywords: Complications; Different approaches; Graves’ orbitopathy; Orbital decompression