The Experts below are selected from a list of 168 Experts worldwide ranked by ideXlab platform
Liu Shi-qian - One of the best experts on this subject based on the ideXlab platform.
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Clinical analysis of 52 cases of primary hyperthyroidism combined with Exophthalmos by surgical treatment
Hainan Medical Journal, 2013Co-Authors: Liu Shi-qianAbstract:Objective To analyze the impact of surgical treatment on patients with primary hypothyroidism combined with Exophthalmos. Methods Fifty-two patients of primary hypothyroidism combined with Exophthalmos were treated with bilateral subtotal thyroidectomy surgery. The thyroid function and Exophthalmos degree were detected 1 day before operation and 1, 3, 6 months after operation. Results Primary hypothyroidism was cured in the 52patients. There was statistically significant differences in Exophthalmos degree 1 day before operation and 1, 3, 6months after operation(P0.05). The Exophthalmos degree gradually reduced, and eye symptoms were improved.Conclusion Surgical treatment is feasible for patients of primary hyperthyroidism combined with Exophthalmos.The Exophthalmos degree of primary hyperthyroidism and mild-to-moderate Exophthalmos can be reduced after surgical treatment, and the eye symptoms can be improved.
Sarah Troxel - One of the best experts on this subject based on the ideXlab platform.
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Treatment of Exophthalmos
Plastic and reconstructive surgery, 1991Co-Authors: Robert M. Pearl, Lars M. Vistnes, Sarah TroxelAbstract:Current procedures for Graves' Exophthalmos fail to achieve complete correction. The standard orbital decompressions were therefore modified to maximize the degree of volumetric increase behind the axis of the globe. In 15 orbits, the preoperative Exophthalmos averaged 9.5 mm, whereas the postoperative Exophthalmos was 4.1 mm. Postoperative CT study demonstrated that the remaining posterior orbital wall, combined with the persistently increased intraocular muscle volume, blocked retrodisplacement of the globe, despite adequate total volumetric increase. The increased muscle volume varied from 2 to 5 cc. Despite this residual Exophthalmos, the modified four-wall expansion provides excellent aesthetic results with visual improvement and resolution of chemosis and exposure keratitis.
Wilmar M Wiersinga - One of the best experts on this subject based on the ideXlab platform.
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the removal of the deep lateral wall in orbital decompression its contribution to Exophthalmos reduction and influence on consecutive diplopia
American Journal of Ophthalmology, 2005Co-Authors: Lelio Baldeschi, Kerr Macandie, Christoph Hintschich, I M M J Wakelkamp, Mark F Prummel, Wilmar M WiersingaAbstract:Purpose To evaluate the contribution of maximal removal of the deep lateral wall of the orbit to Exophthalmos reduction in Graves' orbitopathy and its influence on the onset of consecutive diplopia. Design Case-control study. Methods The medical records of two cohorts of patients affected by Graves' orbitopathy with Exophthalmos ≥23 mm, without preoperative diplopia, were retrieved at random from the pool of patients decompressed for rehabilitative reasons at our institution (01/1990 to 12/2003), and retrospectively reviewed. They had been treated with an extended (cases, group 1, n=15) or conservative (controls, group 2, n=15) 3-wall orbital decompression performed through a coronal approach. The deep portion of the lateral wall had been removed in the extended decompression group while preserved in the conservative decompression group. Demographics, preoperative characteristics, and surgical outcome were compared. The difference in mean Exophthalmos reduction between groups 1 and 2 was considered to be the contribution of the deep lateral wall to reduction of Exophthalmos. Results Groups 1 and 2 were drawn from a pool of 37 and 335 patients, respectively. Demographics and preoperative characteristics of the two groups were not significantly different. The mean contribution of the deep lateral wall to Exophthalmos reduction was 2.3 mm. The onset of consecutive diplopia was not significantly different between the two groups (case n=2/15, controls n=5/15; P = .203). Diplopia resolved spontaneously in all the patients of group 1, while all the patients of group 2 required surgery. Conclusions Removal of the deep lateral orbital wall as part of a coronal-approach, 3-wall decompression, enhances the degree of Exophthalmos reduction without increasing the risk of consecutive diplopia.
Hanspeter Howaldt - One of the best experts on this subject based on the ideXlab platform.
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en bloc resection of the lateral orbital rim to reduce Exophthalmos in patients with graves disease
Journal of Cranio-maxillofacial Surgery, 2010Co-Authors: Heidrun Schaaf, Gregor Santo, Michael Graf, Hanspeter HowaldtAbstract:Summary Introduction Today, elective surgical procedures are performed on patients with thyroid-associated orbitopathy for aesthetic and "quality-of-life" reasons and only rarely in emergency cases to prevent blindness. The surgical methods should have minimal adverse effects and reliable outcomes. Patients and methods En bloc resection of the lateral orbital rim and part of the orbital floor was performed on 44 patients over a 7-year period. An osteotomy was made in the inferolateral wall of the orbit via a subciliary incision and the periorbital tissues were resected. Exophthalmos reduction, postoperative changes in strabismus and extraocular muscle function, visual acuity and follow-on operations were analysed. Results Most patients underwent surgery for Exophthalmos, conjunctival and corneal symptoms. The average Exophthalmos reduction was 3.8±1.5mm (range 1.5–7.5mm, p Conclusion The procedure for Exophthalmos reduction is as effective as other two-wall expansion methods and it features low risks for loss of vision, new-onset diplopia and other disturbances of extraocular motility.
Reza M Vagefi - One of the best experts on this subject based on the ideXlab platform.
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hyperostosing sphenoid wing meningiomas surgical outcomes and strategy for bone resection and multidisciplinary orbital reconstruction
Journal of Neurosurgery, 2021Co-Authors: Cecilia Dalle L Ore, Stephen T Magill, Roberto Rodriguez Rubio, Maryam Shahin, Manish K Aghi, Philip V Theodosopoulos, Javier Villanuevameyer, Robert C Kersten, Oluwatobi O Idowu, Reza M VagefiAbstract:OBJECTIVE Hyperostosing sphenoid wing meningiomas cause bony hyperostosis that may extend into the orbit, resulting in proptosis, restriction of extraocular movements, and/or compressive optic neuropathy. The extent of bony removal necessary and the optimal reconstruction strategy to prevent enophthalmos is debated. Herein, the authors present their surgical outcomes and reconstruction results. METHODS This is a retrospective review of 54 consecutive patients undergoing resection of sphenoid wing meningiomas associated with bony hyperostosis. The majority of cases were operated on by the senior author. Extent of tumor resection, volumetric bone resection, radiographic Exophthalmos index, complications, and recurrence were analyzed. RESULTS The median age of the cohort was 52.1 years, with women comprising 83% of patients. Proptosis was a presenting symptom in 74%, and 52% had decreased visual acuity. The WHO grade was I (85%) or II (15%). The median follow-up was 2.6 years. On volumetric analysis, a median 86% of hyperostotic bone was resected. Gross-total resection of the intracranial tumor was achieved in 43% and the orbital tumor in 27%, and of all intracranial and orbital components in 20%. Orbital reconstruction was performed in 96% of patients. Postoperative vision was stable or improved in 98% of patients and diplopia improved in 89%. Postoperative complications occurred in 44% of patients, and 26% of patients underwent additional surgery for complication management. The most frequent complications were medical complications and extraocular movement deficits. The median preoperative Exophthalmos index was 1.26, which improved to 1.12 immediately postoperatively and to 1.09 at the 6-month follow-up (p < 0.001). Postoperatively, 18 patients (33%) underwent adjuvant radiotherapy after subtotal resection. Tumors recurred/progressed in 12 patients (22%). CONCLUSIONS Resection of hyperostosing sphenoid wing meningiomas, particularly achieving gross-total resection of hyperostotic bone with a good aesthetic result, is challenging and associated with notable medical and ocular morbidity. Recurrence rates in this series are higher than previously reported. Nevertheless, the authors were able to attain improvement in proptosis and visual symptoms in the majority of patients by using a multidisciplinary approach.