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Analysis of the efficacy of transnasal endoscopic annulus of zinn area decompression in the treatment of dysthyroid optic neuropathy – Lumbar Spinal Stenosis

The article evaluated the early efficacy and safety of transnasal endoscopic decompression in the annulus of zinn (AZ) region for refractory dysthyroid optic neuropathy (DON) and analyzed the factors related to postoperative visual function outcome. A total of 35 patients with DON who underwent AZ area decompression were included in the study. Post-surgery, significant improvements were observed in best corrected visual acuity (BCVA), visual field, intraocular pressure, and proptosis. The results also showed that three-wall orbital decompression was more effective in reducing proptosis compared to two-wall orbital decompression. Changes in BCVA, visual field, intraocular pressure, and proptosis were positively correlated with their respective preoperative measurements. The study concluded that endoscopic endonasal decompression of the AZ area is a safe and effective surgical treatment for DON, with notable improvements in BCVA. Three-wall orbital decompression yielded better outcomes in terms of eye retraction

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative spinal hospital on Harley Street UK

Published article

Objective: To evaluate the early efficacy and safety of transnasal endoscopic decompression in the annulus of zinn (AZ) region for refractory dysthyroid optic neuropathy (DON) and to preliminarily analyze the correlated factors of postoperative visual function outcome. Methods: From July 2021 to January 2023, 35 patients (56 eyes) with DON who received AZ area decompression in Peking University Third Hospital were included retrospectively, including 9 males (13 eyes) and 26 females (43 eyes),…

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Dec 7;58(12):1198-1205. doi: 10.3760/cma.j.cn115330-20230420-00181.ABSTRACTObjective: To evaluate the early efficacy and safety of transnasal endoscopic decompression in the annulus of zinn (AZ) region for refractory dysthyroid optic neuropathy (DON) and to preliminarily analyze the correlated factors of postoperative visual function outcome. Methods: From July,

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Dec 7;58(12):1198-1205. doi: 10.3760/cma.j.cn115330-20230420-00181.

ABSTRACT

Objective: To evaluate the early efficacy and safety of transnasal endoscopic decompression in the annulus of zinn (AZ) region for refractory dysthyroid optic neuropathy (DON) and to preliminarily analyze the correlated factors of postoperative visual function outcome. Methods: From July 2021 to January 2023, 35 patients (56 eyes) with DON who received AZ area decompression in Peking University Third Hospital were included retrospectively, including 9 males (13 eyes) and 26 females (43 eyes), aging (52.2±12.0) years. Among them, 35 eyes underwent two-wall (medial and inferior) orbital decompression using an endonasal endoscopic approach, while 21 eyes received three-wall (medial, lateral, and inferior) orbital decompression through a combined approach. Key parameters such as best corrected visual acuity (BCVA), visual field (MD value), eyeball prominence, intraocular pressure, and complications were recorded. Postoperative data were collected one month after surgery. The statistical analysis was performed using paired t-test and Spearman correlation analysis. Results: Significant outcomes were observed post surgery in BCVA, visual field, intraocular pressure and proptosis (t value was 8.37, 6.17, 4.50, and 9.20, respectively, all P<0.001). The reduction in proptosis was statistically significant between the 2-wall and 3-wall orbital decompression groups (t=-2.82, P=0.007). Changes in BCVA, visual field, and intraocular pressure before and after surgery was greater in the 3-wall orbital decompression group compared to 2-wall orbital decompression group, although the difference was not statistically significant (all P>0.05). Change in postoperative visual acuity and visual field was significantly positively correlated with preoperative visual acuity and preoperative visual field (all P<0.001). Similarly, change in intraocular pressure and proptosis was positively correlated with preoperative intraocular pressure and preoperative protrusion (all P<0.001). Preoperative diplopia was reported in seven patients (20.0%), and two new cases (5.7%) were noted post-operation, which resolved within 3 months after surgery. Conclusions: Endoscopic endonasal decompression of the AZ area is a safe and effective surgical treatment for DON, with notable improvements in BCVA. Furthermore, three-orbital wall decompression seems to yield better outcomes in terms of eye retraction.

PMID:38186094 | DOI:10.3760/cma.j.cn115330-20230420-00181

The London Spine Unit : innovative spinal hospital on Harley Street UK

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Analysis of the efficacy of transnasal endoscopic annulus of zinn area decompression in the treatment of dysthyroid optic neuropathy

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Dec 7;58(12):1198-1205. doi: 10.3760/cma.j.cn115330-20230420-00181.ABSTRACTObjective: To evaluate the early efficacy and safety of transnasal endoscopic decompression in the annulus of zinn (AZ) region for refractory dysthyroid optic neuropathy (DON) and to preliminarily analyze the correlated factors of postoperative visual function outcome. Methods: From July

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