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Impressum
Angle of deviation followed endonasal decompression in comparison to external decompression in Graves´ ophthalmopathy
1Keilhauer C. N., 2Schwager K., 1Sold J. E., 1Schäfer W. D.
1Department of Ophthalmology, 2Otorhinolaryngology University of Würzburg
Objective: To demonstrate the influence of two operative methods
on the development of angle of deviation in Graves´ disease.
Patients and Methods: Bilateral transnasal orbital decompression
was performed on 16 patients, external decompression on 36 patients in
the period from 1997 to May 2001. All patients suffered from Graves´ophthalmopathy
in advanced stage. Prior to decompression patients underwent systemic
therapy with steroids and/or radiation therapy of the orbit. Follow-up
examination dates ranged from 1-12 months postoperatively with an average
of 5,1 months (± 2,5).
Results: Mean measurements of extraorbital prominence in transnasal
decompression was 5,0 mm versus 4,1 mm in external decompression. Mean
visual acuity improved for 0,07 in transnasal decompression and 0,1 in
external decomression. Horizontal angle of deviation followed endonasal
decompression on an average of 21,7 pdpt (± 18,7) in contrast to
6,3 pdpt (± 7,4) in external decompression. Mean vertical angle
of deviation was 7,8 pdpt (± 9,6) in transnasal, 2,3 pdpt (±
3,1) in external decompression,. Incyclorotations were measured on an
average 2,7 pdpt (± 3,4) in endonasal of 0,9 pdpt (± 2,2)
in external, decompression. Further strabismus surgery was necessary in
12 of 16 patients after endonasal decompression in contrast to 11 of 36
patients after external decompression.
Conclusion: In spite of lower complication rate transnasal decompression
showed greater angle of deviation requireing further muscle surgery.