This retrospective study looked at the outcome of endoscopic medial wall combined with transcutaneous lateral orbital wall decompression in Graves’ orbitopathy. The following parameters were studied: reduction in proptosis; change in visual acuity and diplopia. A total of 36 orbits were operated with a mean follow-up of 44 months.

An average of 3.5 mm proptosis reduction was achieved which seems to be similar to other studies. Visual acuity was shown to have improved in all compressive optic neuropathy cases (five cases) and diplopia was cured in eight patients (40%).

Postoperative complications in the study seemed to be minimal. Eyelid surgery for lid retraction was required in 13 patients with hyaluronic acid injection as the most used technique. Key points in this study include the recommendation for use of a consistent, standardised two wall technique and use of a multidisciplinary team approach, namely ENT / oculoplastic for achieving best surgical results. The paper would be better if cosmetic outcomes were included.

Balanced (endoscopic medial and transcutaneous lateral) orbital decompression in Graves’ orbitopathy.
Hernández-García E, San-Román JJ, González R, et al.
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Sangeeta Maini

FRCS ORL-HNS, Aberdeen Royal Infirmary, Forresterhill, Aberdeen, AB25 2ZN.

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Bhaskar Ram

FRCS (EDIN) , FRCS ORL-HNS, Department of Otolaryngology Head & Neck Surgery, Aberdeen Royal Infirmary, Forresterhill, Aberdeen AB25 2ZN, UK.

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