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Summary

Orbitofrontal craniotomy with direct orbitotomy gives broad surgical access to the anterior cranial fossa and orbit. Indications for this combined technique vary and are dependent on the location and nature of the lesion. This technique can also be used for orbital decompression in severe cases of Graves’ orbitopathy. A complete clinical history with imaging is critical for preoperative planning. Postoperatively, close monitoring of vision and neurological status is critical to identifying and preventing complications.

Aim:

To document the results of endoscopic orbital decompression performed in a group of patients with thyroid eye disease in order to improve cosmesis.

Methods:

A retrospective case review was performed of all patients who had undergone endoscopic orbital decompression for cosmesis in our departments during the period January 1996 to September 2002. A postal questionnaire was sent to all patients who had undergone the operation, in order to assess patient satisfaction.

Results:

Twenty orbits of 15 patients underwent endoscopic decompression. For all orbits, the reduction in proptosis was 3.7±2.2 mm (mean±standard deviation; t = 6.5, p = 0.001). For 16 of the endoscopic decompressions (89 per cent), patients reported that they were satisfied with the appearance of their eye post-operatively, and all patients reported a reduction in eye prominence post-operatively.

Conclusion:

Endoscopic decompression is an effective procedure for improving cosmesis in patients with inactive thyroid eye disease.

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Chapter 9 - Combined Orbitofrontal Craniotomy and Direct Orbital Decompression

Summary

Endoscopic orbital decompression for dyscosmetic thyroid eye disease

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Chapter 9 - Combined Orbitofrontal Craniotomy and Direct Orbital Decompression

Summary

Endoscopic orbital decompression for dyscosmetic thyroid eye disease