Analysis Of The Effect Of Endoscopic Orbital Decompression For Patients With Thyroid Associated Ophthalmopathy

Objective:To evaluate the therapeutic effect of endonasal endoscopic orbital decompression for patients with thyroid associated ophthalmopathy.Methods:A retrospective series of case studies were conducted on 19 cases(30 eyes)of TAO patients who received endonasal endoscopic orbital decompression from June2013 to October 2018.Among them,9 cases(15 eyes)were operated on due to simple exophthalmos,10 cases(15 eyes)were operated on due to compressive optic neuropathy,11 eyes had simple inner wall orbital decompression and 19 eyes had inner wall combined with inferior wall orbital decompression.Preoperative and postoperative exophthalmos,orbital pressure,the volume of the orbital cavity,eye movement and postoperative complications were recorded and compared.Results:9 cases(15 eyes)were operated due to simple exophthalmos,the ocular protrusion was(19.5±3.3)mm before operation,(16.0±3.0)mm after operation,and the average retraction was(3.5±0.6)mm.Postoperative orbital pressure returned to normal.There were 10 eyes with ocular dyskinesia before surgery,but all were relieved after surgery.There was no new diplopia or increased degree of diplopia after surgery.There were only 2 new cases of esotropia after surgery.10 cases(15eyes)were operated due to CON,the degree of eyeball protrusion of was(18.5±2.9)mm before surgery,(14.8±2.3)mm after surgery,and the mean regression was(3.7±1.2)mm.The uncorrected visual acuity before surgery was 0.12±0.09,0.43±0.26after operation,and the average increase was 0.27±0.25.The preoperative sputum volume was(23.48±2.65)cm~3,postoperatively(25.75±2.87)cm~3,and the postoperative sputum volume increased by an average of(2.27±0.71)cm~3.Postoperative orbital pressure returned to normal.Preoperatively,12 eyes had dyspraxia,but all were relieved after surgery.No new diplopia or increased degree of diplopia were found after surgery.Postoperative esotropia occurred in 2 cases.Conclusion:Endoscopic decompression surgery can effectively relieve ocular protrusion.There is no scar on the face,and a satisfactory postoperative appearance can be obtained after surgery.The operation can effectively expand the volume of the orbital cavity,relieve the orbital apex congestion and optic nerve compression of CON patients,and save the eyesight.In addition,this method has less trauma,faster recovery,less postoperative complications,and is relatively safe.