Long-term improvement of clinical symptoms after endoscopic sinus surgery in patients suffered from endocrine ophthalmopathy and orbital complications of rhinosinusitis

Abstract

Background: Rhinosinusitis may cause serious complications, such as secondary orbital infections, resulting in expansion and erosion of process through the orbital wall.

Aims: The aim is to evaluate long-term outcome of ESS in patients suffered from endocrine ophthalmopathy and orbital complications of rhinosinusitis.

Material and methods: Thirteen patients with loss of vision, endocrine ophthalmopathy and orbital complication of rhinosinusitis were treated by ESS. Preoperative and postoperative vision was rated by best-corrected visual acuity (BCVA) testing. Nine (69%) have been reinvestigated after 6 years by ophthalmology examination and 10-point scale for assessment of clinical symptoms.

Results: The mean BCVA significantly increased after surgery comparing to results before surgery (0.84, 0.62; respectively) (p = .007). The mean values of 10-point scale for subjective assessment of symptoms 6 years after surgery were: headache 2.11, sinonasal pressure 1.72, subjective estimation of vision quality on the affected eye was 7.33 and olfaction 7.66. None of the patients developed impairment of vision loss in postoperative period.

Conclusions: Long-term outcome of ESS showed decreased symptoms in patients who had endocrine ophthalmopathy and orbital complication of rhinosinusitis.

Significance: ESS has numerous advantages for patients with orbital complication and vision loss comparing to conservative treatment and should be considered even in abscess absence.

背景：鼻窦炎可能会引起严重的并发症, 例如继发性眼眶感染, 导致眶壁扩张和侵蚀。

目的：目的是评估患有内分泌性眼病和鼻窦炎眼眶并发症的患者的ESS治疗的长期结果。

材料和方法：13例视力丧失、内分泌眼病和鼻窦炎眼眶并发症的患者接受ESS治疗。通过最佳矫正视力（BCVA）测试评估术前和术后视力。 6年后, 通过眼科检查和临床症状评估的10分量表重新调查了其中的9例（69％）。

结果：术后平均BCVA显著高于手术前的结果（分别为0.84和0.62）（p = .007）。手术后6年主观评估症状的10分量表的平均值为：头痛2.11；鼻窦压力1.72；受影响眼睛视力质量的主观估计值为7.33；嗅觉7.66。所有患者均未出现术后视力丧失。

结论：ESS的长期结果显示患有内分泌性眼病和鼻窦炎眼眶并发症的患者症状减轻。

意义：与保守治疗相比, ESS对眼眶并发症和视力丧失患者有许多好处, 即使在没有脓肿的情况下也应予以考虑使用。

Keywords:

• Endocrine ophthalmopathy
• orbital complication
• rhinosinusitis
• endoscopic sinus surgery
• vision loss

Disclosure statement

No conflict of interest and financial disclosures.

Additional information

Funding

Dr Aleksandra Barac received support for research from the Project of Ministry of Education, Science and Technology of the Republic of Serbia (No. III45005).