PURPOSE

To investigate the feasibility, efficacy, and safety of endoscopic transconjunctival transorbital deep lateral wall decompression for thyroid-associated orbitopathy (TAO).

DESIGN

Prospective single-surgeon interventional case series.

METHODS

Twenty-two patients (39 orbits) diagnosed with thyroid-associated orbitopathy without dysthyroid optic neuropathy were enrolled in this study. All patients underwent endoscopic transconjunctival transorbital deep lateral wall decompression for proptosis reduction. The data, including measurement on exophthalmometry, volumetric change on computed tomography, and surgery-related complications, were analyzed.

RESULTS

We observed a proptosis reduction (mean, 3.42 ± 0.87 mm; range, 2.10–5.52 mm) and a corresponding decrease in the bony volume of the greater wing of the sphenoid bone (mean, 1.89 ± 0.81 cm³; range, 0.56–3.79 cm³) postoperatively. Preexisting diplopia improved in 5 patients (22.73%). Transient zygomaticotemporal hypoesthesia developed in all patients, and cerebrospinal fluid leakage occurred in 1 orbit (2.56%). No patient complained of temporal hollowing, oscillopsia, or new-onset or worsening diplopia during follow-up.

CONCLUSIONS

Endoscopic transconjunctival transorbital deep lateral wall decompression is an effective and minimally invasive treatment for proptosis reduction in patients with thyroid-associated orbitopathy. The surgery-related complications with this technique were fewer compared with traditional approaches.

中文翻译：

---

内镜下经结膜深层外侧壁减压术治疗甲状腺相关眼眶病：一种微创替代方案

目的

探讨内镜下经结膜经眶深部外侧壁减压术治疗甲状腺相关眼眶病（TAO）的可行性、有效性和安全性。

设计

前瞻性单外科医生介入病例系列。

方法

本研究招募了 22 名诊断为甲状腺相关眼眶病但无甲状腺功能障碍视神经病变的患者（39 个眼眶）。所有患者均接受内镜下经结膜经眶深部外侧壁减压术以减少眼球突出。分析了这些数据，包括突眼测量法的测量、计算机断层扫描的体积变化和手术相关的并发症。

结果

我们观察到眼球突出减少（平均，3.42 ± 0.87 mm；范围，2.10-5.52 mm）和蝶骨大翼的骨体积相应减少（平均，1.89 ± 0.81 cm ³；范围，0.56-3.79 cm ³ ) 术后。5 名患者 (22.73%) 先前存在的复视得到改善。所有患者均出现一过性颧颞叶感觉减退，1个眼眶发生脑脊液漏（2.56%）。在随访期间，没有患者抱怨颞空洞、振动性斜视或新发或恶化的复视。

结论

内镜下经结膜经眶深部外侧壁减压术是一种有效的微创治疗方法，可减少甲状腺相关眼病患者的眼球突出。与传统方法相比，这种技术的手术相关并发症更少。