28. Nghiên cứu ứng dụng phẫu thuật nội soi giảm áp hốc mắt điều trị bệnh hốc mắt liên quan tuyến giáp
Nội dung chính của bài viết
Tóm tắt
Nghiên cứu can thiệp lâm sàng không đối chứng, được tiến hành trên 65 mắt của 42 bệnh nhân được phẫu thuật nội soi giảm áp hốc mắt từ tháng 1/2018 đến tháng 12/2021 tại Bệnh viện Quân Y 103. Chỉ định phẫu thuật bao gồm: lồi mắt: 34 mắt, chèn ép thị thần kinh: 31 mắt. Độ lồi của nhóm lồi mắt giảm trung bình 2,02 ± 1,06mm. Nhóm chèn ép thị thần kinh thị lực tăng trung bình tương đương với 3,1 dòng Snellen. Biến chứng chảy máu gặp ở 6/65 mắt (9,2%), viêm xoang sau mổ gặp ở 2/65 mắt (3,1%), viêm tổ chức hốc mắt gặp ở 1/65 mắt (1,5%). Song thị tăng nặng gặp ở 9/42 bệnh nhân. Thị lực trước mổ càng tốt tương quan với thị lực sau mổ càng tốt, độ lồi trước mổ càng cao tương quan với mức giảm độ lồi càng cao. Việc bảo tồn mảnh xương góc dưới trong ổ mắt cùng sàn ổ mắt gắn với tỷ lệ song thị thấp và mức giảm độ lồi thấp.
Chi tiết bài viết
Từ khóa
phẫu thuật nội soi giảm áp hốc mắt, bệnh mắt liên quan tuyến giáp
Tài liệu tham khảo
1. Hiromatsu Y, Eguchi H, Tani J, Kasaoka M, Teshima Y. Graves’ ophthalmopathy: Epidemiology and natural history. Internal medicine (Tokyo, Japan). 2014;53(5):353-60. doi: 10.2169/internalmedicine.53.1518.
2. Bartalena L, Piantanida E, Gallo D, Lai A, Tanda ML. Epidemiology, Natural History, Risk Factors, and Prevention of Graves’ Orbitopathy. Frontiers in endocrinology. 2020;11:615993. doi: 10.3389/fendo.2020.615993.
3. Gioacchini FM, Kaleci S, Cassandro E, et al. Orbital wall decompression in the management of Graves’ orbitopathy: A systematic review with meta-analysis. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. Nov 2021;278(11):4135-4145. doi: 10.1007/s00405-021-06698-5.
4. Pletcher SD, Sindwani R, Metson R. Endoscopic orbital and optic nerve decompression. Otolaryngologic clinics of North America. Oct 2006;39(5):943-58, vi. doi: 10.1016/j.otc.2006.06.003.
5. She YY, Chi CC, Chu ST. Transnasal endoscopic orbital decompression: 15-year clinical experience in Southern Taiwan. Journal of the Formosan Medical Association. Sep 2014;113(9):648-55. doi: 10.1016/j.jfma.2012.08.009.
6. Woods RSR, Pilson Q, Kharytaniuk N, Cassidy L, Khan R, Timon CVI. Outcomes of endoscopic orbital decompression for graves’ ophthalmopathy. Irish journal of medical science. Feb 2020;189(1):177-183. doi: 10.1007/s11845-019-02043-2.
7. Gulati S, Ueland HO, Haugen OH, Danielsen A, Rodahl E. Long-term follow-up of patients with thyroid eye disease treated with endoscopic orbital decompression. Acta ophthalmologica. Mar 2015;93(2):178-83. doi: 10.1111/aos.12469.
8. Yuen AP, Kwan KY, Chan E, Kung AW, Lam KS. Endoscopic transnasal orbital decompression for thyrotoxic orbitopathy. Hong Kong medical journal. Dec 2002;8(6):406-10.
9. Nguyễn Chiến Thắng. Nghiên cứu ứng dụng phẫu thuật giảm áp hốc mắt điều trị bệnh mắt Basedow mức độ nặng. Luận án tiến sĩ y học, Trường Đại học Y Hà Nội; 2014.
10. Currò N, Covelli D, Vannucchi G, et al. Therapeutic outcomes of high-dose intravenous steroids in the treatment of dysthyroid optic neuropathy. Thyroid: official journal of the American Thyroid Association. May 2014;24(5):897-905. doi: 10.1089/thy.2013.0445.
11. Barrio-Barrio J, Sabater AL, Bonet-Farriol E, Velázquez-Villoria Á, Galofré JC. Graves’ Ophthalmopathy: VISA versus EUGOGO Classification, Assessment, and Management. Journal of Ophthalmology. 2015;2015:249125. doi: 10.1155/2015/249125.
12. Kasperbauer JL, Hinkley L. Endoscopic orbital decompression for Graves’ ophthalmopathy. American journal of rhinology. Nov-Dec 2005;19(6):603-6.
13. Finn AP, Bleier B, Cestari DM, et al. A retrospective review of orbital decompression for Thyroid Orbitopathy with Endoscopic Preservation of the Inferomedial Orbital Bone Strut. Ophthalmic plastic and reconstructive surgery. 2017;33(5):334-339. doi: 10.1097/iop.0000000000000782.
14. Minasyan L, Zangwill L, Kikkawa DO. Risk factors associated with double vision after orbital decompression in patients with Thyroid-Related Orbitopathy (TRO). Investigative Ophthalmology & Visual Science. 2010;51(13):3920-3920.
15. Rajabi MT, Ojani M, Esfahani HR, Tabatabaei SZ, Rajabi MB, Hosseini SSJJoCO. Correlation of peripapillary nerve fiber layer thickness with visual outcomes after decompression surgery in subclinical and clinical thyroid-related compressive optic neuropathy. J Curr Ophthalmol. 2018;31(1):86-91.
16. Liang Q-W, Yang H, Luo W, He J-F, Du YJM. Effect of orbital decompression on dysthyroid optic neuropathy: A retrospective case series. Medicine (Baltimore). 2019;98(3).
17. Neigel JM, Rootman J, Belkin RI, et al. Dysthyroid optic neuropathy. The crowded orbital apex syndrome. Ophthalmology. Nov 1988;95(11):1515-21. doi: 10.1016/s0161-6420(88)32978-7.
18. Dolman PJ. Dysthyroid optic neuropathy: Evaluation and management. Journal of endocrinological investigation. Mar 2021;44(3):421-429. doi: 10.1007/s40618-020-01361-y.
19. Borumandi F, Hammer B, Kamer L, von Arx G. How predictable is exophthalmos reduction in Graves’ orbitopathy? A review of the literature. Br J Ophthalmol. Dec 2011;95(12):1625-30. doi: 10.1136/bjo.2010.181313.
20. Thapa S, Gupta AK, Gupta A, Gupta V, Dutta P, Virk RS. Proptosis reduction by clinical vs radiological modalities and medial vs inferomedial approaches: Comparison following endoscopic transnasal orbital decompression in patients with dysthyroid orbitopathy. JAMA otolaryngology-- head & neck surgery. Apr 2015;141(4):329-34. doi: 10.1001/jamaoto.2014.3659.
2. Bartalena L, Piantanida E, Gallo D, Lai A, Tanda ML. Epidemiology, Natural History, Risk Factors, and Prevention of Graves’ Orbitopathy. Frontiers in endocrinology. 2020;11:615993. doi: 10.3389/fendo.2020.615993.
3. Gioacchini FM, Kaleci S, Cassandro E, et al. Orbital wall decompression in the management of Graves’ orbitopathy: A systematic review with meta-analysis. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. Nov 2021;278(11):4135-4145. doi: 10.1007/s00405-021-06698-5.
4. Pletcher SD, Sindwani R, Metson R. Endoscopic orbital and optic nerve decompression. Otolaryngologic clinics of North America. Oct 2006;39(5):943-58, vi. doi: 10.1016/j.otc.2006.06.003.
5. She YY, Chi CC, Chu ST. Transnasal endoscopic orbital decompression: 15-year clinical experience in Southern Taiwan. Journal of the Formosan Medical Association. Sep 2014;113(9):648-55. doi: 10.1016/j.jfma.2012.08.009.
6. Woods RSR, Pilson Q, Kharytaniuk N, Cassidy L, Khan R, Timon CVI. Outcomes of endoscopic orbital decompression for graves’ ophthalmopathy. Irish journal of medical science. Feb 2020;189(1):177-183. doi: 10.1007/s11845-019-02043-2.
7. Gulati S, Ueland HO, Haugen OH, Danielsen A, Rodahl E. Long-term follow-up of patients with thyroid eye disease treated with endoscopic orbital decompression. Acta ophthalmologica. Mar 2015;93(2):178-83. doi: 10.1111/aos.12469.
8. Yuen AP, Kwan KY, Chan E, Kung AW, Lam KS. Endoscopic transnasal orbital decompression for thyrotoxic orbitopathy. Hong Kong medical journal. Dec 2002;8(6):406-10.
9. Nguyễn Chiến Thắng. Nghiên cứu ứng dụng phẫu thuật giảm áp hốc mắt điều trị bệnh mắt Basedow mức độ nặng. Luận án tiến sĩ y học, Trường Đại học Y Hà Nội; 2014.
10. Currò N, Covelli D, Vannucchi G, et al. Therapeutic outcomes of high-dose intravenous steroids in the treatment of dysthyroid optic neuropathy. Thyroid: official journal of the American Thyroid Association. May 2014;24(5):897-905. doi: 10.1089/thy.2013.0445.
11. Barrio-Barrio J, Sabater AL, Bonet-Farriol E, Velázquez-Villoria Á, Galofré JC. Graves’ Ophthalmopathy: VISA versus EUGOGO Classification, Assessment, and Management. Journal of Ophthalmology. 2015;2015:249125. doi: 10.1155/2015/249125.
12. Kasperbauer JL, Hinkley L. Endoscopic orbital decompression for Graves’ ophthalmopathy. American journal of rhinology. Nov-Dec 2005;19(6):603-6.
13. Finn AP, Bleier B, Cestari DM, et al. A retrospective review of orbital decompression for Thyroid Orbitopathy with Endoscopic Preservation of the Inferomedial Orbital Bone Strut. Ophthalmic plastic and reconstructive surgery. 2017;33(5):334-339. doi: 10.1097/iop.0000000000000782.
14. Minasyan L, Zangwill L, Kikkawa DO. Risk factors associated with double vision after orbital decompression in patients with Thyroid-Related Orbitopathy (TRO). Investigative Ophthalmology & Visual Science. 2010;51(13):3920-3920.
15. Rajabi MT, Ojani M, Esfahani HR, Tabatabaei SZ, Rajabi MB, Hosseini SSJJoCO. Correlation of peripapillary nerve fiber layer thickness with visual outcomes after decompression surgery in subclinical and clinical thyroid-related compressive optic neuropathy. J Curr Ophthalmol. 2018;31(1):86-91.
16. Liang Q-W, Yang H, Luo W, He J-F, Du YJM. Effect of orbital decompression on dysthyroid optic neuropathy: A retrospective case series. Medicine (Baltimore). 2019;98(3).
17. Neigel JM, Rootman J, Belkin RI, et al. Dysthyroid optic neuropathy. The crowded orbital apex syndrome. Ophthalmology. Nov 1988;95(11):1515-21. doi: 10.1016/s0161-6420(88)32978-7.
18. Dolman PJ. Dysthyroid optic neuropathy: Evaluation and management. Journal of endocrinological investigation. Mar 2021;44(3):421-429. doi: 10.1007/s40618-020-01361-y.
19. Borumandi F, Hammer B, Kamer L, von Arx G. How predictable is exophthalmos reduction in Graves’ orbitopathy? A review of the literature. Br J Ophthalmol. Dec 2011;95(12):1625-30. doi: 10.1136/bjo.2010.181313.
20. Thapa S, Gupta AK, Gupta A, Gupta V, Dutta P, Virk RS. Proptosis reduction by clinical vs radiological modalities and medial vs inferomedial approaches: Comparison following endoscopic transnasal orbital decompression in patients with dysthyroid orbitopathy. JAMA otolaryngology-- head & neck surgery. Apr 2015;141(4):329-34. doi: 10.1001/jamaoto.2014.3659.