Возможности хирургического лечении эндокринной офтальмопатии. Взгляд оториноларинголога

Abstract

Background : Endocrine ophthalmopathy is a complex pathology in endocrinology and ophthalmology. It is multidisciplinary question, located at the junction of endocrinology and ophthalmology. Currently, the treatment of endocrine ophthalmopathy there are not many surgical approaches which differ in their effectiveness and safety. One of the most popular methods is transethmoid orbit decompression to the removal of the medial wall of the orbit and medial part of the orbital bottom. In addition, we can say unequivocally that this method slows down the progression of the disease, thereby improving visual acuity and quality of life. Aim : To assess the possibilities of endocrine ophthalmopathy surgical treatment – transethmoidal orbital decompression, according to reduce of exophthalmos. Methods : 64 patients with endocrine ophthalmopathy were included in the study with ineffective drug treatment, the surgical treatment of which was conducted from 2006 to 2016. Transethmoidal orbital decompression was performed on 90 orbits. Results : All patients in the postoperative period showed persistent positive dynamics, expressed in decreasing exophthalmos and improving the quality of life due to the disappearance of the cosmetic defect. However, in all patients, we observed varying degrees of transient or persistent postoperative diplopia. None of the patients had orbital infectious complications or other clinically significant infections of the nasal cavity and paranasal sinuses. Conclusion : In our study, the high clinical efficacy of transethmoidal orbit decompression with respect to the regression of exophthalmos was demonstrated. Exophthalmos on average decreased in all patients by 5.1 mm, and the level of postoperative diplopia was less than 20% of cases.