鼻内镜入路(EEA)最初用于治疗甲状腺眼眶病和眼球突出。从那以后,这种方法也已被用于治疗其他原因的突出。该综述系统地确定了接受内镜经鼻内镜眼眶减压术的无甲状腺突出症患者的手术结果和并发症发生率。
使用以下搜索词搜索数据库:眼眶疾病,手术减压,内镜经鼻入路。两名独立审稿人筛选了所有摘要和标题的相关性,所有通过此筛选的文章都要进行全文审查。为了评估偏见的风险,我们使用ROBINS-I(非随机干预研究中的偏倚风险)。
纳入了8项研究,共74例非甲状腺突出症患者。所有研究均进行了术前和术后眼部检查,但是检查的程度各不相同。平均年龄为35.7岁,大多数患者是青少年,大多数病理导致单侧眼球突出的眼眶减压术的EEA并发症是短暂性复视(5例/6.8%),短暂性面部感觉迟钝(2例/2.7%),上睑下垂(1名患者/1.4%),梗塞(1名患者/1.4%),鼻窦阻塞(1例/1.4%),和enophtalmos(1名患者/1.4%)。作者报告说,除2例患者外,所有患者都成功减少了眼球突出(97.2%),只有2位作者报告需要二次减压.
使用EEA的眼眶内侧减压术是治疗非甲状腺突出症患者眼眶减压的可行方法。虽然主要结果与经眶入路具有可比性,EEA在并发症发生率方面似乎更优.
The endoscopic endonasal approach (EEA) was originally performed to treat thyroid orbitopathy and proptosis. Since then, this approach also has been used to treat other causes of proptosis. This
review systematically identifies surgical outcome and complication rates in patients without thyroid proptosis who underwent endoscopic endonasal
orbital decompression.
Databases were searched using the following search terms:
orbital disease, surgical decompression, and endoscopic endonasal approach. Two independent reviewers screened all abstracts and titles for relevance and all articles passing this screen were subjected to full-text
review. To assess risk of bias, we used ROBINS-I (Risk Of Bias in Non-randomized Studies-of Interventions).
Eight studies with a total of 74 patients with nonthyroid proptosis were included. Pre- and postoperative eye examination was performed in all studies, but the extent of examination was varying. With a mean age of 35.7 years, most patients were adolescent, and most pathologies induced unilateral proptosis Complications to EEA for orbital decompression were transient diplopia (5 patients/6.8%), transient facial dysesthesia (2 patients/2.7%), ptosis (1 patient/1.4%), infarction (1 patient/1.4%), sinus obstruction (1 patient/1.4%), and enophtalmos (1 patient/1.4%). The authors reported successful reduction of proptosis in all but 2 patients (97.2%), and only 2 authors reported a need for secondary decompression.
Medial
orbital decompression using EEA is a feasible approach for
orbital decompression in patients with nonthyroid proptosis. While being comparable in primary outcome to transorbital approaches, the EEA seems superior in terms of complication rates.