Open Access
CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(04): e579-e584
DOI: 10.1055/s-0041-1740156
Original Research

Adjunctive Middle Turbinectomy for Endoscopic Medial Orbital Wall – Thyroid Eye Disease Decompression

Andrea A. Tooley 
1   Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
,
Matthew Kim
3   Department of Otolaryngology – Head and Neck Surgery, Division of Rhinology and Anterior Skull Base Surgery, New York-Presbyterian Hospital, New York, New York
,
Ann Q. Tran
2   Oculoplastic and Orbital Surgery, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
,
Michael Kazim
2   Oculoplastic and Orbital Surgery, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
,
David A. Gudis
3   Department of Otolaryngology – Head and Neck Surgery, Division of Rhinology and Anterior Skull Base Surgery, New York-Presbyterian Hospital, New York, New York
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Abstract

Introduction Middle turbinate resection (MTR) is commonly performed during endonasal endoscopic sinus and skull base surgery.

Objective The purpose of this study was to characterize the additional orbital soft-tissue volume expansion during endoscopic medial orbital wall decompression with adjunctive MTR.

Methods A retrospective review of patients who underwent endoscopic medial wall decompression with MTR was performed. The imaging software AW (GE Healthcare, Chicago, IL, USA) was used to overlay pre and postoperative orbital computed tomography (CT) images to visualize the preoperative position of the middle turbinate and the postoperative orbital soft tissue in the ethmoid bed. The imaging software Vitrea (Vital Images Inc., Minnetonka, MN, USA) was used to manually segment postoperative scans to determine the volume of orbital tissue which had filled the space previously occupied by the middle turbinate or medial to it.

Results Nine orbits from 5 patients were included in this study; all patients were female with a history of hyperthyroidism. The average age was 55.6 years (range 32–74). Of the 9 orbits, 7 (78%) had orbital soft tissue within the space of the resected middle turbinate postoperatively. The average volume of orbital tissue within or medial to this space was 0.83 +/− 0.67 cc. No patients had any postoperative complications.

Conclusions In this patient cohort, adjunctive middle turbinate resection for endoscopic medial orbital wall decompression added ∼ 0.83 cc of volume for orbital soft tissue after medial wall decompression. Middle turbinate resection is a useful adjunct to the orbital surgeon's armamentarium to augment the results of a medial orbital decompression for select patients.

Keywords

Middle turbinate - orbital decompression - thyroid eye disease

Financial Disclosures

None.


Meeting Presentations

None.




Publication History

Received: 18 December 2020

Accepted: 07 May 2021

Article published online:
08 February 2022

© 2022. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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