MINIMALLY INVASIVE METHODS OF SURGICAL TREATMENT OF ENDOCRINE OPHTHALMOPATHY
“Balanced” bone decompression of the orbit was performed in a patient with endocrine ophthalmopathy, CAS3, OD=30 mm, OS=31 mm with the use of minimally invasive transconjunctival approaches and frameless neuronavigation. At the first stage the preoperative computed tomography of the orbits ...
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Format: | Article |
Language: | Russian |
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Ophthalmology Publishing Group
2017-07-01
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Series: | Oftalʹmologiâ |
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Online Access: | https://www.ophthalmojournal.com/opht/article/view/379 |
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author | O. V. Levchenko A. A. Kalandari A. Yu. Grigoriev N. Yu. Kutrovskaya О. N. Timofeeva |
author_facet | O. V. Levchenko A. A. Kalandari A. Yu. Grigoriev N. Yu. Kutrovskaya О. N. Timofeeva |
author_sort | O. V. Levchenko |
collection | DOAJ |
description | “Balanced” bone decompression of the orbit was performed in a patient with endocrine ophthalmopathy, CAS3, OD=30 mm, OS=31 mm with the use of minimally invasive transconjunctival approaches and frameless neuronavigation. At the first stage the preoperative computed tomography of the orbits was imported into the navigation software, and then marked the area of the proposed resection of the orbit walls. Further, in the operating room, the patient was registered in the navigation system. To perform bone decompression of the orbit and lipectomy, we used preseptal, transcaruncular and lateral retrocanthal approaches. These approaches are transconjunctival and do not leave postoperative scars. Upon completion of the orbitotomy, its accuracy and dimensions were determined by the intraoperative pointer of the neuronavigation system.Results. The postoperative period was uneventful. In the early postoperative period there was a regression of exophthalmus OD=26 mm, OS=27 mm, closure of the eye gap, but retraction of the eyelids remained. When examined 3 months after the operation, the exophthalmic regression was OD=23 mm, OS=24 mm, retraction of the eyelids — 1 mm, with lead — finishing to the lateral adhesion. When examined after 6 months — the position of the eyeballs in orbit: ОD=21 mm, ОS=22 mm, retraction of the eyelids is not present, there is no violation of oculomotorics, complications were not recorded. A satisfactory result was obtained.Conclusion. Minimally invasive transorbital approaches allow the transconjunctival acces to all orbital walls to perform decompression of the orbit and lipectomy without cutaneous incisions, to achieve good cosmetic and functional results. And the intraoperative use of the neuronavigation system ensures the bone decompression of the orbit in full. The technique is promising and requires further randomized studies. |
first_indexed | 2024-04-10T01:48:11Z |
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id | doaj.art-c8c7f4339d644776a4aedeae9ee9b029 |
institution | Directory Open Access Journal |
issn | 1816-5095 2500-0845 |
language | Russian |
last_indexed | 2024-04-10T01:48:11Z |
publishDate | 2017-07-01 |
publisher | Ophthalmology Publishing Group |
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series | Oftalʹmologiâ |
spelling | doaj.art-c8c7f4339d644776a4aedeae9ee9b0292023-03-13T09:08:37ZrusOphthalmology Publishing GroupOftalʹmologiâ1816-50952500-08452017-07-0114216316910.18008/1816-5095-2017-2-163-169343MINIMALLY INVASIVE METHODS OF SURGICAL TREATMENT OF ENDOCRINE OPHTHALMOPATHYO. V. Levchenko0A. A. Kalandari1A. Yu. Grigoriev2N. Yu. Kutrovskaya3О. N. Timofeeva4ФГБОУ ВО Московский государственный медико-стоматологический университет им. А.И. Евдокимова МЗ РФФГБОУ ВО Московский государственный медико-стоматологический университет им. А.И. Евдокимова МЗ РФФГБУ «Эндокринологический научный центр» МЗ РФФГБОУ ВО Московский государственный медико-стоматологический университет им. А.И. Евдокимова МЗ РФГБУЗ «Эндокринологический диспансер ДЗ г. Москвы»“Balanced” bone decompression of the orbit was performed in a patient with endocrine ophthalmopathy, CAS3, OD=30 mm, OS=31 mm with the use of minimally invasive transconjunctival approaches and frameless neuronavigation. At the first stage the preoperative computed tomography of the orbits was imported into the navigation software, and then marked the area of the proposed resection of the orbit walls. Further, in the operating room, the patient was registered in the navigation system. To perform bone decompression of the orbit and lipectomy, we used preseptal, transcaruncular and lateral retrocanthal approaches. These approaches are transconjunctival and do not leave postoperative scars. Upon completion of the orbitotomy, its accuracy and dimensions were determined by the intraoperative pointer of the neuronavigation system.Results. The postoperative period was uneventful. In the early postoperative period there was a regression of exophthalmus OD=26 mm, OS=27 mm, closure of the eye gap, but retraction of the eyelids remained. When examined 3 months after the operation, the exophthalmic regression was OD=23 mm, OS=24 mm, retraction of the eyelids — 1 mm, with lead — finishing to the lateral adhesion. When examined after 6 months — the position of the eyeballs in orbit: ОD=21 mm, ОS=22 mm, retraction of the eyelids is not present, there is no violation of oculomotorics, complications were not recorded. A satisfactory result was obtained.Conclusion. Minimally invasive transorbital approaches allow the transconjunctival acces to all orbital walls to perform decompression of the orbit and lipectomy without cutaneous incisions, to achieve good cosmetic and functional results. And the intraoperative use of the neuronavigation system ensures the bone decompression of the orbit in full. The technique is promising and requires further randomized studies.https://www.ophthalmojournal.com/opht/article/view/379эндокринная офтальмопатия«сбалансированная» декомпрессия глазницынейронавигация |
spellingShingle | O. V. Levchenko A. A. Kalandari A. Yu. Grigoriev N. Yu. Kutrovskaya О. N. Timofeeva MINIMALLY INVASIVE METHODS OF SURGICAL TREATMENT OF ENDOCRINE OPHTHALMOPATHY Oftalʹmologiâ эндокринная офтальмопатия «сбалансированная» декомпрессия глазницы нейронавигация |
title | MINIMALLY INVASIVE METHODS OF SURGICAL TREATMENT OF ENDOCRINE OPHTHALMOPATHY |
title_full | MINIMALLY INVASIVE METHODS OF SURGICAL TREATMENT OF ENDOCRINE OPHTHALMOPATHY |
title_fullStr | MINIMALLY INVASIVE METHODS OF SURGICAL TREATMENT OF ENDOCRINE OPHTHALMOPATHY |
title_full_unstemmed | MINIMALLY INVASIVE METHODS OF SURGICAL TREATMENT OF ENDOCRINE OPHTHALMOPATHY |
title_short | MINIMALLY INVASIVE METHODS OF SURGICAL TREATMENT OF ENDOCRINE OPHTHALMOPATHY |
title_sort | minimally invasive methods of surgical treatment of endocrine ophthalmopathy |
topic | эндокринная офтальмопатия «сбалансированная» декомпрессия глазницы нейронавигация |
url | https://www.ophthalmojournal.com/opht/article/view/379 |
work_keys_str_mv | AT ovlevchenko minimallyinvasivemethodsofsurgicaltreatmentofendocrineophthalmopathy AT aakalandari minimallyinvasivemethodsofsurgicaltreatmentofendocrineophthalmopathy AT ayugrigoriev minimallyinvasivemethodsofsurgicaltreatmentofendocrineophthalmopathy AT nyukutrovskaya minimallyinvasivemethodsofsurgicaltreatmentofendocrineophthalmopathy AT ontimofeeva minimallyinvasivemethodsofsurgicaltreatmentofendocrineophthalmopathy |