PMID: 9658833Jul 11, 1998Paper

Orbital decompression in treatment of endocrine orbitopathy

Mund-, Kiefer- und Gesichtschirurgie : MKG
S TvetenJ Esser

Abstract

Graves' ophthalmopathy (Graves' disease) is a grave, rare immunological inflammatory reaction of the postorbital connective, adipose and ocular muscle tissue. Graves' disease occurs only within the scope of immunothyropathies and constitutes the most frequently encountered extrathyroidal manifestation. Typical symptoms are a result of the volume increase of the postbulbar connective and adipose tissue and of the interstitial swelling of the ocular muscles. Clinically, we find a spectrum of increasingly grave changes in the orbita, such as infiltration of the eyelid and connective tissue, exophthalmos, swelling of the muscles, damage to the cornea and involvement of the optic nerve with loss of vision. Regarding functional impairment of the optic nerve (optic nerve compression), orbita decompression represents an operative ultima ratio. Between January 1992 and April 1997, 11 patients (22 orbitae) from a group of more than 600 patients with Graves' disease with vision involvement were treated surgically. All treatment data were documented prospectively. Surgical intervention was performed only in cases where a progressive loss of vision existed in spite of retrobulbar irradiation and high-dose glucocorticoid therapy. Surgical th...Continue Reading

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