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Endoscopic orbital decompression for proptosis in non-thyroid eye disease

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Abstract

Purpose

Orbital decompression is an established surgical treatment option for a range of orbital conditions. We report the outcomes of endonasal decompression to recess the globe for conditions and pathologies other than thyroid eye disease.

Methods

This was a retrospective case series of patients who underwent endoscopic orbital decompression for proptosis secondary to non-thyroid eye disease orbital pathologies. The procedures were carried out by oculoplastic surgeons across two hospital sites between January 2011 and July 2018. Information collected includes patient demographics, diagnosis, surgical details, pre- and postoperative clinical findings (including visual acuity, exophthalmometry readings, intraocular pressure, ocular motility and diplopia), complications and further treatment.

Results

There were seven cases of endoscopic decompression, each due to a different pathology. The reasons for decompression were proptosis secondary to optic nerve sheath meningioma (1); sphenoid wing meningioma (1); idiopathic myositis (1); axial myopia (1); chronic third nerve palsy (1); to protuberant keratoprosthesis (1); and Crouzon syndrome with corneal exposure (1). Visual acuity remained stable or improved in all patients postoperatively. There was an average reduction in proptosis of 3.5 ± 1.4 mm (standard deviation - SD). Ocular motility remained stable in 100% (7/7). There were no intraoperative or postoperative complications, including no new cases of postoperative diplopia.

Conclusions

Endoscopic orbital decompression can be performed for patients with proptosis associated with a large globe, facial dysplasia or medial and infero-medial orbital lesions.

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia

    Valerie Juniat, David Curragh & Dinesh Selva

  2. Department of Ears, Nose and Throat, Princess Royal Hospital,, RX16 4EX, Haywards Heath, UK

    J Anthony McGilligan

  3. Department of Ophthalmology, Sussex Eye Hospital, Eastern Road, Brighton, BN2 5BF, UK

    Saul Rajak

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  1. Valerie Juniat
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  2. J Anthony McGilligan
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  3. David Curragh
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  4. Dinesh Selva
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  5. Saul Rajak
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Correspondence to Valerie Juniat.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Juniat, V., McGilligan, J.A., Curragh, D. et al. Endoscopic orbital decompression for proptosis in non-thyroid eye disease. Oral Maxillofac Surg 24, 85–91 (2020). https://doi.org/10.1007/s10006-019-00826-6

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  • DOI: https://doi.org/10.1007/s10006-019-00826-6

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