Impact of the ethmoid volume on endoscopic medial wall decompression outcomes in Graves' orbitopathy. (1st November 2020)

• Record Type: Journal Article
• Authors: Clarós, Pedro; Waląg, Agnieszka; López-Fortuny, Marta; Clarós, Andrés
• Is Part Of: Acta oto-laryngologica. Volume 140:Number 11(2020)
• Page Start: 948
• Page End: 953
• Publication Date: 2020-11-01
• Subjects: Graves' orbitopathy -- thyroid eye disease -- ethmoid sinus volume -- proptosis reduction; Otolaryngology -- Periodicals; Ear -- Diseases -- Periodicals; Throat -- Diseases -- Periodicals; Otolaryngology -- Electronic Resources; Otorhinolaryngologic Diseases; 617.8
• DOI: 10.1080/00016489.2020.1816655
• Languages: English
• ISSNs: 0001-6489

Abstract

Abstract: Background: Endoscopic orbital decompression is a well-established technique for Graves orbitopathy treatment. Aims: Measurement of the ethmoid volume and its correlation with proptosis reduction in patients undergoing endoscopic orbital decompression for Graves' orbitopathy. Methods: We retrospectively reviewed clinical charts of 209 patients (319 orbits) operated by a surgeon at our institution between 1998 and 2019. Results: Average age was 46.9 years. About 83.3% of the patients were female, 54.6% were smokers, 93.8% were euthyroid at the time of decompression, 3.8% were hypothyroid and 2.4% were hyperthyroid. About 77.5% of the patients underwent bilateral surgery, the remainder and unilateral. Subsequent stages included strabismus surgery in 22.5% patients, Müllerectomy 37.8%, with or without canthoplasty (14.8 vs. 23%). Mean proptosis reduction was 4.61 mm. Mean ethmoid volume was 5.57 mm 3 . Ethmoid volume had a moderate positive correlation with proptosis reduction ( r s = 0.49, p < .001). Further investigation, statistically significant moderate correlation was found only in the small (SE) and big (BE) ethmoid groups. Conclusion: We advise evaluating ethmoid sinus pneumatization on computed tomography before decompression to estimate possible anatomical limitations. Additional wall decompression might be advocated in most severe cases.