Transorbital Endoscopic Medial Orbitotomy and Decompression of the Optic Nerve in Patients with Endocrine Ophthalmopathy Complicated by Optical Neuropathy
https://doi.org/10.23934/2223-9022-2020-9-1-167-172
Abstract
AIM OF STUDY: to improve the results of surgical treatment of patients with endocrine ophthalmopathy complicated by optical neuropathy. For this, medial orbitotomy and decompression of the optic nerve were performed for a patient with endocrine ophthalmopathy, CAS<3, OD=18 mm, OS=23 mm and visual acuity OD=1.0 OS=0.2, using transorbital transconjunctival endoscopic access. The first step was a retro caruncular incision. After that, we defined an access to the medial wall of the orbit with its subsequent resection. Then, we performed ethmoidectomy and approach to the optic nerve canal. Upon completion of bone decompression, we opened periorbitis.
RESULTS. The postoperative period was uneventful. In the early postoperative period, regression of exophthalmos was observed OD=18 mm, OS=20 mm, improvement in visual acuity OD=1.0 OS=0.5 . No complications were recorded. A satisfactory result was obtained.
CONCLUSION. Transorbital endoscopic medial orbitotomy and optic decompression can be effectively used in the treatment of patients with endocrine ophthalmopathy complicated by optic neuropathy, refractory to conservative therapy. The technique is promising and requires further randomized studies.
About the Authors
O. V. Levchenko
Clinical Medical Center, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of Russian Federation
Russian Federation
Dr. Med. Sci., Prorector for Studying
Russian Federation
Dr. Med. Sci., Prorector for Studying
A. A. Kalandari
Clinical Medical Center, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of Russian Federation
Russian Federation
Alik A. Kalandari, Cand. Med. Sci., Chief Physician
Russian Federation
Alik A. Kalandari, Cand. Med. Sci., Chief Physician
N. Y. Kutrovskaya
Clinical Medical Center, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of Russian Federation
Russian Federation
Cand. Med. Sci., Neuroophthalmologist
Russian Federation
Cand. Med. Sci., Neuroophthalmologist
K. V. Revazyan
Clinical Medical Center, A.I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of Russian Federation
Russian Federation
Postgraduate student, Department of Neurosurgery and Neuroresuscitation
Russian Federation
Postgraduate student, Department of Neurosurgery and Neuroresuscitation
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Review
For citations:
Levchenko O.V., Kalandari A.A., Kutrovskaya N.Y., Revazyan K.V. Transorbital Endoscopic Medial Orbitotomy and Decompression of the Optic Nerve in Patients with Endocrine Ophthalmopathy Complicated by Optical Neuropathy. Russian Sklifosovsky Journal "Emergency Medical Care". 2020;9(1):167-172. https://doi.org/10.23934/2223-9022-2020-9-1-167-172
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