eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Reconstructive Surgery

Orbital Decompression for Graves Disease: Multimedia

Author: Michael Mercandetti, MD, MBA, FACS, Consulting Staff, Department of Surgery, Doctors Hospital of Sarasota
Coauthor(s): Adam J Cohen, MD, Consulting Surgeon, Myers Wyse Center for the Eye; Director, Center for Facial Rejuvenation; Andrew Marc Marlowe, MD, Private Practice, Sarasota, Florida; David J Terris, MD, FACS, Porubsky Professor and Chairman, Department of Otolaryngology, Medical College of Georgia; Peter Levin, MD, Associate Clinical Professor, Department of Ophthalmology, Stanford University Medical Center
Contributor Information and Disclosures

Updated: Nov 10, 2008

Multimedia

Figure 1A is the frontal view of a patient, taken...Media file 1: Figure 1A is the frontal view of a patient, taken preoperatively. Figure 1B is the frontal view of a patient, taken 6 months postoperatively.
Figure 1A is the frontal view of a patient, taken...

Figure 1A is the frontal view of a patient, taken preoperatively. Figure 1B is the frontal view of a patient, taken 6 months postoperatively.

Figure 2A is the preoperative coronal noncontrast...Media file 2: Figure 2A is the preoperative coronal noncontrast bone window CT scans of a patient. The patient had incidental evidence of chronic sinusitis, which improved radiologically. Figure 2B is the postoperative coronal noncontrast bone window CT scans of a patient, demonstrating typical decompression.
Figure 2A is the preoperative coronal noncontrast...

Figure 2A is the preoperative coronal noncontrast bone window CT scans of a patient. The patient had incidental evidence of chronic sinusitis, which improved radiologically. Figure 2B is the postoperative coronal noncontrast bone window CT scans of a patient, demonstrating typical decompression.

Figure 3A is a frontal view of a patient with exp...Media file 3: Figure 3A is a frontal view of a patient with exposure keratitis preoperatively. Figure 3B is the lateral view of a patient with exposure keratitis preoperatively. Figure 3C is the frontal view of a patient 4 months postoperatively. Figure 3D is the lateral view of a patient 4 months postoperatively.
Figure 3A is a frontal view of a patient with exp...

Figure 3A is a frontal view of a patient with exposure keratitis preoperatively. Figure 3B is the lateral view of a patient with exposure keratitis preoperatively. Figure 3C is the frontal view of a patient 4 months postoperatively. Figure 3D is the lateral view of a patient 4 months postoperatively.

More on Orbital Decompression for Graves Disease

Overview: Orbital Decompression for Graves Disease
Workup: Orbital Decompression for Graves Disease
Treatment: Orbital Decompression for Graves Disease
Follow-up: Orbital Decompression for Graves Disease
Multimedia: Orbital Decompression for Graves Disease
References

References

  1. Naffziger HC. Progressive exophthalmos following thyroidectomy: its pathology and treatment. Ann Surg. 1931;94:582-586.

  2. Walsh TE, Ogura JH. Transantral orbital decompression for malignant exopthalmos. Laryngoscope. 1957;67:544-549.

  3. Garrity JA, Fatourechi V, Bergstralh EJ, et al. Results of transantral orbital decompression in 428 patients with severe Graves' ophthalmopathy. Am J Ophthalmol. Nov 15 1993;116(5):533-47. [Medline].

  4. Rootman J, Stewart B, Goldberg RA. Orbital Surgery A Conceptual Approach. Philadelphia Pa: Lippincott-Raven Publishers; 1995:353-384.

  5. Ing E, Bednarczuk T. Thyroid Ophthalmopathy. www.emedicine.com. 2005;Ophthalmology.

  6. Phillips PH. Newmann, NJ editor. The Orbit. in Ophthalmology Clinics of North America. 14:1. Philadelphia PA: W.B. Saunders Company; Mar 2001:109-127.

  7. Kennedy DW. Functional endoscopic sinus surgery. Technique. Arch Otolaryngol. Oct 1985;111(10):643-9. [Medline].

  8. Metson R, Dallow RL, Shore JW. Endoscopic orbital decompression. Laryngoscope. Aug 1994;104(8 Pt 1):950-7. [Medline].

  9. Goldberg RA. Advances in surgical rehabilitation in thyroid eye disease. Thyroid. Sep 2008;18(9):989-95. [Medline].

  10. Chang EL, Bernardino CR, Rubin PA. Transcaruncular orbital decompression for management of compressive optic neuropathy in thyroid-related orbitopathy. Plast Reconstr Surg. Sep 2003;112(3):739-47. [Medline].

  11. Trokel S, Kazim M, Moore S. Orbital fat removal. Decompression for Graves orbitopathy. Ophthalmology. May 1993;100(5):674-82. [Medline].

  12. Shepard KG, Levin PS, Terris DJ. Balanced orbital decompression for Graves' ophthalmopathy. Laryngoscope. Nov 1998;108(11 Pt 1):1648-53. [Medline].

  13. Kennedy DW, Goodstein ML, Miller NR, et al. Endoscopic transnasal orbital decompression. Arch Otolaryngol Head Neck Surg. Mar 1990;116(3):275-82. [Medline].

  14. Metson R, Shore JW, Gliklich RE, et al. Endoscopic orbital decompression under local anesthesia. Otolaryngol Head Neck Surg. Dec 1995;113(6):661-7. [Medline].

  15. Ben Simon GJ, Mansury AM, Schwarcz RM, et al. Simultaneous orbital decompression and correction of upper eyelid retraction versus staged procedures in thyroid-related orbitopathy. Ophthalmology. May 2005;112(5):923-32. [Medline].

  16. Baldeschi L, Wakelkamp IM, Lindeboom R, et al. Early versus late orbital decompression in Graves' orbitopathy: a retrospective study in 125 patients. Ophthalmology. May 2006;113(5):874-8. [Medline].

  17. Baldeschi L, MacAndie K, Koetsier E, et al. The influence of previous orbital irradiation on the outcome of rehabilitative decompression surgery in graves orbitopathy. Am J Ophthalmol. Mar 2008;145(3):534-540. [Medline].

  18. Goh MS, McNab AA. Orbital decompression in Graves' orbitopathy: efficacy and safety. Intern Med J. Oct 2005;35(10):586-91. [Medline].

  19. Baldeschi L, Lupetti A, Vu P, et al. Reactivation of Graves' orbitopathy after rehabilitative orbital decompression. Ophthalmology. Jul 2007;114(7):1395-402. [Medline].

  20. Baylis HI, Call NB, Shibata CS. The transantral orbital decompression (Ogura technique) as performed by the ophthalmologist: a series of 24 patients. Ophthalmology. Oct 1980;87(10):1005-12. [Medline].

  21. Bednarczuk T, Kiljanski J, Mrowiec T, et al. T cell interactions with extracellular matrix proteins in patients with thyroid-associated ophthalmopathy. Autoimmunity. 1998;27(4):221-30. [Medline].

  22. Ben Simon GJ, Schwarcz RM, Mansury AM, et al. Minimally invasive orbital decompression: local anesthesia and hand-carved bone. Arch Ophthalmol. Dec 2005;123(12):1671-5. [Medline].

  23. Berke RN. A modified Krönlein operation. Trans Am Ophthalmol Soc. 1953;51:193-231.

  24. DeSanto LW. The total rehabilitation of Graves' ophthalmopathy. Laryngoscope. Oct 1980;90(10 Pt 1):1652-78. [Medline].

  25. Hurwitz JJ, Birt D. An individualized approach to orbital decompression in Graves' orbitopathy. Arch Ophthalmol. May 1985;103(5):660-5. [Medline].

  26. Kasperbauer JL, Hinkley L. Endoscopic orbital decompression for Graves' ophthalmopathy. Am J Rhinol. Nov-Dec 2005;19(6):603-6. [Medline].

  27. Leone CR Jr, Piest KL, Newman RJ. Medial and lateral wall decompression for thyroid ophthalmopathy. Am J Ophthalmol. Aug 15 1989;108(2):160-6. [Medline].

  28. Lyons CJ, Rootman J. Orbital decompression for disfiguring exophthalmos in thyroid orbitopathy. Ophthalmology. Feb 1994;101(2):223-30. [Medline].

  29. Maniglia AJ. Fatal and other major complications of endoscopic sinus surgery. Laryngoscope. Apr 1991;101(4 Pt 1):349-54. [Medline].

  30. Petersen IA, Kriss JP, McDougall IR, et al. Prognostic factors in the radiotherapy of Graves' ophthalmopathy. Int J Radiat Oncol Biol Phys. Aug 1990;19(2):259-64. [Medline].

  31. Seiff SR, Shorr N. Nasolacrimal drainage system obstruction after orbital decompression. Am J Ophthalmol. Aug 15 1988;106(2):204-9. [Medline].

  32. Sewall EC. Operative control of progressive exophthalmos. Arch Otolaryngol Head Neck Surg. 1936;24:621-624.

  33. Shorr N, Neuhaus RW, Baylis HI. Ocular motility problems after orbital decompression for dysthyroid ophthalmopathy. Ophthalmology. Apr 1982;89(4):323-8. [Medline].

  34. Weisman RA, Savino PJ. Management of endocrine orbitopathy. Otolaryngol Clin North Am. Feb 1988;21(1):93-102. [Medline].

  35. Wessler S, Avioli LV. Surgical approach to the ophthalmopathy of Graves' disease. JAMA. Jun 7 1971;216(10):1627-31. [Medline].

  36. Wu CH, Chang TC, Liao SL. Results and predictability of fat-removal orbital decompression for disfiguring graves exophthalmos in an Asian patient population. Am J Ophthalmol. Apr 2008;145(4):755-9. [Medline].

Further Reading

Keywords

Graves disease, orbital decompression, orbital decompression for Graves disease, Grave’s disease, Graves eye disease, Grave disease, Graves' orbitopathy, Graves' ophthalmopathy, endocrine orbitopathy, endocrine ophthalmopathy, endocrine-related proptosis, Graves disease treatment, thyroid ophthalmopathy, thyroid orbitopathy, thyroid-related orbitopathy, thyroid-related ophthalmopathy, thyroid eye disease, thyroid-associated orbitopathy, thyroid-related immune orbitopathy, orbital decompression for Graves' disease, exophthalmos, proptosis, thyroid Graves, thyroid ophthalmopathy

Contributor Information and Disclosures

Author

Michael Mercandetti, MD, MBA, FACS, Consulting Staff, Department of Surgery, Doctors Hospital of Sarasota
Michael Mercandetti, MD, MBA, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Ophthalmology, American College of Surgeons, American Society for Laser Medicine and Surgery, American Society of Ophthalmic Plastic and Reconstructive Surgery, Association of Military Surgeons of the US, and Sarasota County Medical Society
Disclosure: Nothing to disclose.

Coauthor(s)

Adam J Cohen, MD, Consulting Surgeon, Myers Wyse Center for the Eye; Director, Center for Facial Rejuvenation
Adam J Cohen, MD is a member of the following medical societies: American Academy of Ophthalmology and American College of Surgeons
Disclosure: Nothing to disclose.

Andrew Marc Marlowe, MD, Private Practice, Sarasota, Florida
Andrew Marc Marlowe, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Tinnitus Association, Florida Medical Association, Medical Society of the State of New York, Sarasota County Medical Society, and Vestibular Disorders Association
Disclosure: Nothing to disclose.

David J Terris, MD, FACS, Porubsky Professor and Chairman, Department of Otolaryngology, Medical College of Georgia
David J Terris, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American Association for the Advancement of Science, American Bronchoesophagological Association, American College of Surgeons, American Head and Neck Society, Federation of American Societies for Experimental Biology, International Association of Endocrine Surgeons, Phi Beta Kappa, Radiation Research Society, Society of University Otolaryngologists-Head and Neck Surgeons, and Triological Society
Disclosure: Nothing to disclose.

Peter Levin, MD, Associate Clinical Professor, Department of Ophthalmology, Stanford University Medical Center
Peter Levin, MD is a member of the following medical societies: American Academy of Ophthalmology and American Society of Ophthalmic Plastic and Reconstructive Surgery
Disclosure: Nothing to disclose.

Medical Editor

Terance (Terry) Ted Tsue, MD, Vice-Chairman for Administrative Affairs, Professor, Residency Program Director, Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine
Terance (Terry) Ted Tsue, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society for Head and Neck Surgery, Association for Research in Otolaryngology, Johns Hopkins Medical and Surgical Association, Missouri State Medical Association, Phi Beta Kappa, and Society of University Otolaryngologists-Head and Neck Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Stephen G Batuello, MD, Consulting Staff, Colorado ENT Specialists
Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, American Medical Association, and Colorado Medical Society
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown

 
 
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