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En Bloc Resection of the Lateral Orbital Rim

By Elaine Moore on 6/7/2009

Today, elective surgical procedures for Graves' ophthalmopathy are primarily used for aesthetic and quality of life reasons rather than to prevent blindness. Procedures should be performed after the active phase of TED has ended and only after significant time has passed to see the outcome of changes that normally occur during the resolution phase of TED.

In an article in the May 2009 issue of the Journal of Craniomaxillofacial Surgery, German researchers describe En bloc resection in 44 patients with TED. Their surgeries were performed over a period of 7 years allowing adequate time for follow-up studies.

Surgery consisted of en bloc resection of the lateral orbital rim and part of the orbital floor. In the procedure an osteotomy was made in the inferolateral wall of the orbit and the tissues surrounding the orbit were resected.

Effects included a reduction of exophthalmos, improvement in strabismus, double vision and extraocular muscule function.

The researchers concluded that this procedure is as effective as two-wall expansion methods and it features low risks for loss of vision, new-onset diplopia and other disturbances of extraocular motility.

Study Authors: J Schaaf, G Santo, M Graf, and HP Howaldt, University of Glessen, Germany



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