Microsurgical endonasal decompression in dysthyroid orbitopathy

Diagnosis of thyroid eye disease can be established by its history, signs, symptoms, clinical and laboratory findings of an autoimmune thyroid disease . Therapy for this disease is limited to a few options, which should be adm inistered depending on its stage and inflammatory activity. When medication and radiation therapy fail indications for decompression are: loss of visu al acuity or visual held defects. increasing strabism and severe keratopath y due to eyelid retraction. Numerous surgical decompression techniques have been described in endocrine orbitopathy. We have adopted endonasal microsu rgery. because this technique gives the freedom to work bimanually, ensures a stereomicoscopic view of the intranasal landmarks of orbital walls and a llows simultaneous decompression of the medial and inferior orbital wall as well as a good relief of pressure at the orbital apex. Decompressions were performed on 27 orbits in 17 patients, via the endonasal microsurgical. 3 via external approach. The microscopic approach was entirely comparable wit h regard to reduction of proptosis with a mean improvement of 4.1 mm agains t a mean of 4.7 mm by external approach and a mean 0.2 of better visual acu ity in both procedures. The microsurgical technique is considered superior to an external approach avoiding external scars. neural pains and reportedl y les;diplopia. Also, trauma to the nalolacrimal and nasofrontal ducts are avoided. The healing phase and the hospitalization time is shorter.