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Orbital decompression

S Sellari-Franceschini, I Dallan, A Bajraktari, G Fiacchini, M Nardi, R Rocchi, C Marcocci, M Marinò, A P Casani
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...
August 2016: Acta Otorhinolaryngologica Italica
Marenza Leo, Teresa Mautone, Ilaria Ionni, Maria Antonietta Profilo, Elena Sabini, Francesca Menconi, Barbara Mazzi, Roberto Rocchi, Francesco Latrofa, Marco Nardi, Paolo Vitti, Claudio Marcocci, Michele Marinò
OBJECTIVE: Intravenous (iv) glucocorticoids (GC) (ivGC) are used for active Graves orbitopathy (GO), but factors affecting GO outcome are poorly understood. We performed a retrospective study to investigate the variables affecting GO after ivGC. METHODS: We evaluated 83 consecutive GO patients treated with ivGC but not orbital radiotherapy (ORT) and re-examined them after a median of 47 months. The endpoints were the relationships between GO outcome or additional treatments with age, sex, smoking habits, thyroid volume, thyroid treatment, time since thyroid treatment, antithyroid-stimulating hormone receptor antibodies (TRAb), GO duration, GO features, and follow-up time...
October 2016: Endocrine Practice
Francesca Menconi, Marenza Leo, Elena Sabini, Teresa Mautone, Marco Nardi, Aldo Sainato, Stefano Sellari-Franceschini, Paolo Vitti, Claudio Marcocci, Michele Marinò
Intravenous glucocorticoids are used for Graves' orbitopathy, alone or associated with/followed by additional treatments (orbital radiotherapy, orbital decompression, palpebral or eye surgery). However, the relation between associated/additional treatments and other variables with Graves' orbitopathy outcome following intravenous glucocorticoids is not clear. Thus, the present study was conducted to investigate retrospectively the impact of associated/additional treatments and other variables on Graves' orbitopathy outcome after intravenous glucocorticoids...
October 5, 2016: Endocrine
Gina-Eva Görtz, Mareike Horstmann, Barbara Aniol, Buena Delos Reyes, Joachim Fandrey, Anja Eckstein, Utta Berchner-Pfannschmidt
CONTEXT: In Graves' ophthalmopathy (GO) inflammation with tissue expansion in a closed compartment like the bony orbit and smoking may cause tissue hypoxia. OBJECTIVES: In this study we investigated whether Hypoxia-inducible factor-1 (HIF-1) action impacts on tissue remodeling in GO with the aim to identify possible new therapeutic targets. DESIGN/SETTING/PARTICIPANTS: Orbital fibroblast (OF) were derived from GO patients and control persons (Ctrl)...
September 9, 2016: Journal of Clinical Endocrinology and Metabolism
Ira Seibel, Veit Maria Hofmann, Hasibe Sönmez, Shideh Schönfeld, Masen Dirk Jumah, Minoo Lenarz, Annekatrin Coordes
OBJECTIVE: Graves' Orbitopathy (GO) has well established treatment guidelines; however, its management is still controversial. The aim was to evaluate the results of medial and mediolateral orbital decompression (OD) in intractable GO. METHODS: Retrospective chart review of all patients with advanced stages of GO, who underwent medial (1-wall) or mediolateral (2-wall) OD between May 2012 and November 2014 in our institution. Ophthalmologic examinations included visual acuity, Hertel exophthalmometry (proptosis), intraocular pressure (IOP), visual field (30:2) and diplopia...
September 5, 2016: Auris, Nasus, Larynx
Avni P Finn, Benjamin Bleier, Dean M Cestari, Melanie A Kazlas, Linda R Dagi, Daniel R Lefebvre, Michael K Yoon, Suzanne K Freitag
PURPOSE: To determine incidence of new-onset diplopia, resolution of preexisting diplopia, and impact on proptosis resulting from endoscopic orbital decompression with and without preservation of the inferomedial orbital strut for thyroid orbitopathy. METHODS: Retrospective review of all patients undergoing endoscopic 2- or 3-wall decompression with or without preservation of the strut for thyroid orbitopathy from January 2012 to June 2015. RESULTS: Twenty-six patients (45 orbits) were included and divided into 4 primary categories: 2-wall decompression with strut preservation (4 orbits, 8%), 2-wall decompression with strut removal (7 orbits, 16%), 3-wall decompression with strut preservation (27 orbits, 60%), and 3-wall decompression with strut removal (7 orbits, 16%)...
September 6, 2016: Ophthalmic Plastic and Reconstructive Surgery
Christopher C Gillis, Eun Hae Chang, Khalid Al-Kharazi, Tom Pickles
AIM: To describe the first case of a secondary meningioma in a patient after radiation treatment for thyroid eye disease (TED). Secondarily to identify any additional cases of secondary malignancy resulting from radiotherapy for thyroid eye disease from our institutional experience. BACKGROUND: Thyroid eye disease (TED) is a self-limiting auto-immune disorder causing expansion of orbital soft tissue from deposition of glycosaminoglycans and collagen, leading to significant cosmetic and functional morbidity...
May 2016: Reports of Practical Oncology and Radiotherapy
Ya O Grusha, D S Ismailova, P A Kochetkov, S S Danilov
UNLABELLED: Precise instrument localization is of great importance in orbital decompression surgery. Different navigation systems were designed to fulfill this task and gained wide acceptance. AIM: to describe principal features and determine advantages of intraoperatively navigated orbital bony decompression. MATERIAL AND METHODS: Data on orbital decompression surgery performed with or without intraoperative image guidance is presented. Each time two surgeons were involved - an ophthalmologist (lateral wall decompression) and otolaryngologist (medial wall decompression)...
July 2016: Vestnik Oftalmologii
Tessa Fayers, Peter M Fayers, Peter J Dolman
We tested the sensitivity and responsiveness of the TED-QOL to rehabilitative surgery in thyroid eye disease (TED). The 3-item TED-QOL and 16-item GO-QOL, which assess quality of life (QoL) in TED, were administered to consecutive patients undergoing rehabilitative surgery. The questionnaires were completed pre-and post-operatively to assess sensitivity (ability to discriminate between different surgical groups) and responsiveness (ability to detect within patient changes over time).56 patients underwent 69 procedures for TED (29 orbital decompressions, 15 strabismus operations, 25 eyelid procedures)...
September 6, 2016: Orbit
Tetsuji Uemura, Takahiro Chuman, Tatsuya Fujii, Aya Morikawa, Mamoru Kikuchi, Hidetaka Watanabe
OBJECTIVE: To ask experts in the field to evaluate a surgeon's experience with a retroseptal transconjunctival approach for the repair of the orbital floor damaged by blowout fracture that the surgeon encountered in 12 East-Asian patients. METHODS: Patients were identified from a database, and a retrospective case note review was conducted. A total of 12 conjunctival procedures were conducted for the repair of blowout fracture with no other complicating fractures...
May 2016: Plastic and Reconstructive Surgery. Global Open
A Ujam, M Perry
Current guidelines for the urgent management of patients with orbital compartment syndrome include immediate lateral canthotomy and cantholysis, followed by surgical decompression. Medical treatment is also advocated to 'buy time' while preparing the patient for theatre. This consists of high-dose steroids, mannitol, and acetazolamide diuretics to reduce swelling and orbital pressure. It is generally recognized that late or delayed intervention is associated with poor outcomes including blindness. With early presentation, given the potential risk to sight, there is generally a low threshold for treating suspected cases...
November 2016: International Journal of Oral and Maxillofacial Surgery
Ji Won Kim, Ka Hyun Lee, Young Jun Woo, Jinna Kim, Ki Chang Keum, Jin Sook Yoon
PURPOSE: To evaluate the effect of orbital radiation prior to surgery on the clinical course and extraocular muscle (EOM) radiologic volume changes after decompression in Graves' orbitopathy (GO). DESIGN: Retrospective, interventional case series METHODS: The medical records of patients treated with orbital decompression for GO and who underwent postoperative orbital computed tomography were reviewed. Only patients who underwent rehabilitative decompression in the inactive phase and who received systemic corticosteroids alone (ST group) or combined orbital radiation and systemic corticosteroids (SRT group) in the active inflammatory phase of the disease were selected...
August 16, 2016: American Journal of Ophthalmology
Yoshiyuki Kitaguchi, Yasuhiro Takahashi, Jacqueline Mupas-Uy, Hirohiko Kakizaki
The aim of this study was to identify characteristics of dehiscence of the lamina papyracea found on computed tomography (CT) before orbital and endonasal endoscopic surgeries.The authors retrospectively reviewed the medical records of all patients who underwent orbital tumor removal, orbital decompression, and dacryocystorhinostomy from January 2012 to December 2015. The diagnosis of dehiscence of the lamina papyracea was made based on a bone defect with protrusion of orbital fat into the ethmoid sinus on CT, with no history of orbital trauma and/or eye movement disturbance on the same side...
October 2016: Journal of Craniofacial Surgery
Robert R Hagan, Michael A Fallucco, Jeffrey E Janis
BACKGROUND: Supraorbital rim syndrome (SORS) is a novel term attributed to a composite of anatomically defined peripheral nerve entrapment sites of the supraorbital rim region. The SORS term establishes a more consistent nomenclature to describe the constellation of frontal peripheral nerve entrapment sites causing frontal headache pain. In this article, we describe the anatomical features of SORS and evidence to support its successful treatment using the transpalpebral approach that allows direct vision of these sites and the intraconal space...
July 2016: Plastic and Reconstructive Surgery. Global Open
Jung Woo Byun, Sena Hwang, Chan Woo Kang, Jin Hee Kim, Min Kyung Chae, Jin Sook Yoon, Eun Jig Lee
PURPOSE: Protocatechuic aldehyde (3,4-dihydroxybenzaldehyde; PCA) is extracted from Salvia miltiorrhiza, and has been reported to possess antiproliferative, antioxidant, and antiadipogenesis properties in various in vivo and in vitro experiments. This study aimed to outline the antioxidant and suppressive effects of PCA on adipogenesis and hyaluronan production in orbital fibroblasts to help with designing therapeutic approaches for Graves' orbitopathy (GO). METHODS: We assessed the in vitro effects of PCA on orbital fibroblasts, which were cultured from orbital fat tissue obtained from patients undergoing orbital decompression for severe GO...
August 1, 2016: Investigative Ophthalmology & Visual Science
Iñigo San-Miguel, Ruth Carmona, Luis Luque, Raquel Cabrera, Marta Lloret, Francisco Rutllan, Pedro Carlos Lara
BACKGROUND: Graves' ophthalmopathy is the commonest extrathyroidal manifestation of Graves' disease. Treatment options include steroid therapy, corrective/decompressive surgery, radiation therapy or combination of these approaches. AIM: Our purpose was to investigate if retro-orbital irradiation with Volumetric Modulated Arc Therapy (VMAT) yielded better target coverage and dose sparing to adjacent normal structures compared to 3-Dimensional Conformal Radiotherapy (3DCRT) and Lateral Opposing Conformed Fields (LOCF)...
September 2016: Reports of Practical Oncology and Radiotherapy
Daniel B Rootman, Shani Golan, Peter Pavlovich, Jack Rootman
INTRODUCTION: Surgical rehabilitation of thyroid orbitopathy involves reducing proptosis, treating strabismus, lengthening the eyelids, and managing aesthetic changes. Not all are necessary in each patient; however, they often are. The current investigation intends to describe postdecompression changes that may influence the staging of these procedures. METHODS: In this retrospective cohort study, records of 169 patients who underwent orbital decompression between 1983 and 2001 were reviewed...
August 1, 2016: Ophthalmic Plastic and Reconstructive Surgery
Chih-Ying Wu, Hsiang-Ming Huang, Der-Cherng Chen, Der-Yang Cho, Sung-Tai Wei
A primary intraosseous hemangioma (IOH) of the orbital bone is extremely rare. The preferred method of treatment for IOH is total surgical excision with reconstruction. Herein, the authors describe a patient with an orbital roof IOH and the unexpected complications of ptosis and deteriorated exophthalmos. These findings showed that the total surgical excision and subsequent reconstruction provided adequate decompression and prevented further ocular complications from the orbital wall defect.
September 2016: Journal of Craniofacial Surgery
Lindsay L Wong, Nahyoung Grace Lee, Dhanesh Amarnani, Catherine J Choi, Diane R Bielenberg, Suzanne K Freitag, Patricia A D'Amore, Leo A Kim
PURPOSE: The human orbit is an environment that is vulnerable to inflammation and edema in the setting of autoimmune thyroid disease. Our study investigated the tenet that orbital adipose tissue lacks lymphatic vessels and analyzed the clinicopathologic differences between patients with acute and chronic thyroid eye disease (TED). The underlying molecular mediators of blood and lymphatic vessel formation within the orbital fat also were evaluated. DESIGN: Retrospective cohort study...
September 2016: Ophthalmology
Ryota Tamura, Tomoru Miwa, Yoshiaki Sakamoto, Maya Kohno, Kazuo Kishi, Kazunari Yoshida
INTRODUCTION: Patients with fronto-orbital fibrous dysplasia (FD) occasionally present fronto-orbital protrusion, exophthalmos, and visual acuity disturbance. Simultaneous management of these conditions has not been previously described. CASE DESCRIPTION: A-10-year-old female with fronto-orbital FD complained of left visual acuity disturbance. Head computed tomography showed compressed optic canal secondary to thickened bone. Decompression of the optic canal via the left frontotemporal extradural approach, opening of the lateral orbital wall, and dissection of the prominent zygoma were done simultaneously...
2016: SpringerPlus
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