Endoscopic Decompression of the Orbit in Thyroid Disease

In thyroid hyperfunction, the thyroid hormones may cause swelling of the muscles and fat surrounding the eye. This produces increase of pressure inside the orbit, which is the bony box containing the eyeball. The eye is pushed out (exophthalmos). This condition, apart from causing the obvious aesthetic problem, may also put the vision in danger, due to pressure damage to the sensitive optic nerve. Therefore, in selected cases of exophthalmos, surgical decompression of the orbit may be necessary.

 

Traditional surgical techniques use external incisions to remove part of the bony walls of the orbit. Endoscopic surgery provides a much simpler alternative, when indicated. Through the nostril, without external incisions, the endoscopic surgeon removes the thin bony wall between the nose and the orbit, and allows relief of the increased pressure towards the nasal cavity. Before any decompression procedure, a thorough evaluation by both the Endocrinologist and the Ophthalmologist is needed. The specialized Ophthalmic surgeon, called occuloplastic surgeon, is usually present during the operation.