Research progress of endoscope-assisted transnasal orbital decompression

doi:10.3969/j.issn.1674-8115.2021.12.021

Abstract

Abstract:

Endoscopic orbital decompression has become a mature surgical method because of the development of endoscope. The surgery through transnasal approach makes use of the natural sinus to avoid surgical scar and the endoscope visualizes the surgical area to reduce the risk. Many studies have demonstrated that transnasal endoscopic orbital decompression can reduce the proptosis and cause no severe complications. Using endoscope to apply transnasal orbital decompression has many operation schemes, which may have influence on the result of surgery and the occurrence of complications. This review is to introduce the application of endoscope to orbital decompression and its effectiveness and safety.

Key words: endoscope, thyroid-associated ophthalmopathy, orbital decompression

CLC Number:

R775.9

Rou SUN, Hui-fang ZHOU. Research progress of endoscope-assisted transnasal orbital decompression[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(12): 1692-1697.

Figures/Tables 3

TrendMD

References 39

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Author	Year	Patients	Approach	Subjects	Removed Orbital Wall	Proptosis reduction/mm	Visual acuity	New on-set diplopia	Complications
Eloy P， et al.^［20］	2000	TAO	Transnasal	16 patients 27 orbits	Medial	3.17	0.80→0.95	50.0% （8/16）	‒
Juniat V， et al.^［21］	2019	Inactive TAO or active TAO without DON	Transnasal	24 orbits	Medial	3.50	No vision loss	‒	No other complications
Lv ZG， et al.^［22］	2016	DON	Transnasal	43 patients 72 orbits	Medial	6.20	An improvement of 0.55	11.6% （5/43）	No other complications
Wu WC， et al.^［23］	2015	Inactive TAO	Transnasal	108 patients 206 orbits	Medial	8.20	‒	23.1% （25/108）	17.6% epistaxis，1.9% intraorbital hemorrhages and 2.7% orbital emphysema
Hernández-García E， et al.^［24］	2017	Inactive TAO or DON	Transnasal and Transcutaneous	20 patients 36 orbits	Medial and Lateral	3.50	DON：0.40→0.80	15.0% （3/20）	5.0% post-operative epistaxis and 5.0% cerebrospinal fluid leak
Unal M， et al.^［25］	2000	Inactive TAO or DON	Transnasal and Transcutaneous	9 patients　14 orbits	Medial and Lateral	4.80	Improvement in 2 DON patients	22.2% （2/9）	No other complications

Author	Year	Patients	Approach	Subjects	Removed Orbital Wall	Proptosis reduction/mm	Visual acuity	New on-set diplopia	Complications
Eloy P， et al.^［20］	2000	TAO	Transnasal	16 patients 27 orbits	Medial	3.17	0.80→0.95	50.0% （8/16）	‒
Juniat V， et al.^［21］	2019	Inactive TAO or active TAO without DON	Transnasal	24 orbits	Medial	3.50	No vision loss	‒	No other complications
Lv ZG， et al.^［22］	2016	DON	Transnasal	43 patients 72 orbits	Medial	6.20	An improvement of 0.55	11.6% （5/43）	No other complications
Wu WC， et al.^［23］	2015	Inactive TAO	Transnasal	108 patients 206 orbits	Medial	8.20	‒	23.1% （25/108）	17.6% epistaxis，1.9% intraorbital hemorrhages and 2.7% orbital emphysema
Hernández-García E， et al.^［24］	2017	Inactive TAO or DON	Transnasal and Transcutaneous	20 patients 36 orbits	Medial and Lateral	3.50	DON：0.40→0.80	15.0% （3/20）	5.0% post-operative epistaxis and 5.0% cerebrospinal fluid leak
Unal M， et al.^［25］	2000	Inactive TAO or DON	Transnasal and Transcutaneous	9 patients　14 orbits	Medial and Lateral	4.80	Improvement in 2 DON patients	22.2% （2/9）	No other complications

Author	Year	Patient	Approach	Subject	Removed orbital wall	Proptosis reduction /mm	Visual acuity	New on-set diplopia	Complications
Lal P， et al.^［29］	2013	Inactive TAO or DON	Transnasal	12 patients 24 orbits	Medial and inferior （strut removed）	3.70	Improved significantly in 50.0% orbits with DON	100% （resolved over the next 8 weeks）	8.3% unilateral frontal sinus obstruction
Baradaranfar MH， et al.^［30］	2004	Active or inactive TAO（one DON）	Transnasal	21 patients 42 orbits	Medial and inferior （strut removed）	4.10	Not DON 0.50→0.67 DON OS：HM→0.13 OD：0.25→0.33	71.4% （15/21）	‒
Malik R， et al.^［31］	2008	Inactive TAO	Transnasal	15 patients 20 orbits	Medial and inferior （strut unremoved）	3.70	‒	26.7% （4/15）	6.7% sinusitis and 6.7% post-operative rhinorrhoea
Shi WJ， et al.^［32］	2015	Active or inactive TAO （no DON）	Transnasal and Transcutaneous	6 patients　12 orbits	Medial inferior and lateral （strut removed）	6.41	0.23→0.48	50.0% （3/6）（recovered in 3-5 months）	‒
Cansiz H， et al.^［33］	2006	Active or inactive TAO（one DON）	Transnasal and Transcutaneous	7 patients 8 orbits	Medial inferior and lateral （strut unremoved）	7.75	2 eyes 0.70→1.00 1 eye 0.80→1.00 No change in other 5 eyes	14.3% （1/7）	14.3% maxillary sinusitis

Author	Year	Patient	Approach	Subject	Removed orbital wall	Proptosis reduction /mm	Visual acuity	New on-set diplopia	Complications
Lal P， et al.^［29］	2013	Inactive TAO or DON	Transnasal	12 patients 24 orbits	Medial and inferior （strut removed）	3.70	Improved significantly in 50.0% orbits with DON	100% （resolved over the next 8 weeks）	8.3% unilateral frontal sinus obstruction
Baradaranfar MH， et al.^［30］	2004	Active or inactive TAO（one DON）	Transnasal	21 patients 42 orbits	Medial and inferior （strut removed）	4.10	Not DON 0.50→0.67 DON OS：HM→0.13 OD：0.25→0.33	71.4% （15/21）	‒
Malik R， et al.^［31］	2008	Inactive TAO	Transnasal	15 patients 20 orbits	Medial and inferior （strut unremoved）	3.70	‒	26.7% （4/15）	6.7% sinusitis and 6.7% post-operative rhinorrhoea
Shi WJ， et al.^［32］	2015	Active or inactive TAO （no DON）	Transnasal and Transcutaneous	6 patients　12 orbits	Medial inferior and lateral （strut removed）	6.41	0.23→0.48	50.0% （3/6）（recovered in 3-5 months）	‒
Cansiz H， et al.^［33］	2006	Active or inactive TAO（one DON）	Transnasal and Transcutaneous	7 patients 8 orbits	Medial inferior and lateral （strut unremoved）	7.75	2 eyes 0.70→1.00 1 eye 0.80→1.00 No change in other 5 eyes	14.3% （1/7）	14.3% maxillary sinusitis

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