鼻内镜下经鼻眶减压术治疗甲状腺机能障碍性眶病

Endoscopic transnasal orbital decompression for dysthyroid orbitopathy

目的 探讨甲状腺机能障碍性眶病的眶减压手术方法及其疗效。方法 对 9例 15眼患甲状腺机能障碍性眶病并严重影响视觉功能和容貌者 ,行内镜下经鼻眶减压术。结果 术后随访6个月～ 2年 (平均 1年 ) ,眼球突出度、视力、平视睑裂高度分别从术前的 ( 2 1 93± 1 49)mm、0 5 7±0 12、( 11 0 7± 1 44 )mm改善为术后 1年的 ( 16 87± 1 2 5 )mm、0 69± 0 12、( 8 2 0± 1 15 )mm。术后眶压较术前明显降低 (P <0 0 0 1)。 7眼复视 ,术后 3眼复视消失。结论 由操作熟练的耳鼻咽喉科医师行内镜下经鼻眶减压术 ,具有视野清晰 ,手术精确、安全 ,创伤小 ,并发症少等优点 。

Objective To evaluate the effect of endoscopic transnasal orbital decompression for patients with dysthyroid orbitopathy. Methods Nine cases (15 eyes) of dysthyroid orbitopathy were included in this study. All patients were treated by transnasal endoscopic orbital decompression. Results The follow-up ranged from 6 months to 2 years. Proptosis measured by exophthalmoter reduced from (21.93±1.49) mm to (16.87±1.25) mm after operation. The visual acuity improved from 0.57±0.12 to 0.69±0.12, the palpebral fissures reduced from (11.07±1.44) mm to (8.20±1.15) mm. Postoperatively, the orbital pressure was significantly decreased as compared with the preoperative result (P<0.001). Diplopia was cured in 3 of 7 cases. Conclusion Endoscopic transnasal orbital decompression is an effective method for the treatment of dysthyroid orbitopathy.