Combined endoscopic medial and inferior orbital decompression with transcutaneous lateral orbital decompression in Graves' orbitopathy.

Abstract

To determine the clinical efficacy and morbidity of combined endoscopic transnasal medial and inferior wall orbital decompression performed in conjunction with transcutaneous lateral orbital decompression. Retrospective noncomparative case series. Thirty-four subjects (64 orbits) underwent combined orbital decompression procedures for treatment of Graves' orbitopathy. Transnasal endoscopic medial wall and floor with simultaneous transcutaneous lateral orbital decompression. Ocular motility, visual acuity, and exophthalmometry. No new ocular motility disturbances occurred. There was a mean gain of 0.7 Snellen lines in acuity (range +9 to -10 lines). A mean proptosis reduction of 4.2 mm was observed (range 1-9 mm). Combined endoscopic transnasal medial and inferior orbital wall decompression done in conjunction with transcutaneous lateral orbital decompression carries a low risk of morbidity, including new onset motility disorders, and yields anatomic retropulsion of the globe that is comparable to other methods.