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Abstract

Graves? disease is the most common cause of hyperthyroidism, accounting for approximately 85% of the cases. Graves? orbitopathy (GO) may precede or follow the general manifestations of hyperthyroidism. Manifestations of GO include eyelid retraction, proptosis, chemosis, diplopia, corneal exposure and optic neuropathy. Surgical treatment is recommended in cases of optic neuropathy, excessive proptosis, corneal ulceration, secondary glaucoma, incapacitating pain, and also to relieve the side effects of corticoid therapy. We report out 10 years experience with orbital expansion combining the transpalpebral and endoscopic trans-nasal approach in patients with GO. Technical details of the surgical procedure are discussed. A new method of quantifying axial proptosis in patients with GO is also presented. Despite being a highly complex procedure, requiring a significant knowledge of otolaryngology, ophthalmology and plastic surgery, the combined trans-nasal and transpalpebral orbital expansion is safe and efficient, leading to significant reduction of proptosis with minimal complications.

Biography