Avtor/Urednik		Podboj, Jernej; Boršoš, Imre; Kurent, Zoran
Naslov		Endoskopski posegi v očnicah
Prevedeni naslov		Endoscopic surgery of the orbits
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 39, št. Suppl 3
Leto izdaje		2000
Obseg		str. 265-9
Jezik		slo
Abstrakt		Introduction: The development of the endoscopic surgical technique and modern diagnostic methods, along with the introduction of powered instrumentation and computer-assisted surgery allow the widening of indications for the use of endoscopic surgery in the management of pathological processes of the orbit. Patients: At the Otorhinolaryngology and Cervicofacial Surgery Department in Ljubljana, 21 patients with pathological processes of the orbits have undergone endoscopic surgery since 1988. Twelve patients underwent endoscopic drainage of orbital abscesses resulting from sinusitis, and one endoscopic drainage of an orbital hematoma. Five patients with endocrine ophthalmopathy had bilateral orbital decompression, while one patient with neurofibromatosis had unilateral orbital decompression. One female patient underwent endoscopic removal of an orbital hemangioma, and a male had an endoscopic orbital biopsy that verified metastatic carcinoma. Results: There were no intraoperative or postoperative complications. After endoscopic drainage of the orbital abscesses and hematoma, the condition normalised within 24 hours. Following endoscopic orbital decompression, exophthalmos was reduced by an average of 2 mm. The patient who underwent endoscopic removal of an orbital hemangioma still has no symptoms 6 years after surgery. The patient with verified metastasis in the orbit received local radiotherapy. Discussion: The endoscopic surgical technique permits an accurate approach to pathological processes in the lower and medial orbital regions. Close cooperation between the ENT surgeon and the ophthalmologist and radiologist is important. Compared to classical surgery, endoscopic operations are much less traumatic and stressful for the patient, the postoperative course is less unpleasant, the hospital stay is shorter, and the patient has no visible postoperative scars.
Izvleček		Uvod. Razvoj endoskopske kirurške tehnike in sodobne diagnostike, uvajanje visokozmožnih instrumentov in računalniško podprte kirurgije omogoča širitev indikacij za endoskopske posege pri patoloških procesih v predelu očnic. Bolniki. Na Kliniki za otorinolaringologijo in cervikofacialno kirurgijo v Ljubljani smo od leta 1988 endoskopsko operirali 21 bolnikov z bolezenskimi procesi v očnicah. Pri petih bolnikih z endokrino oftalmopatijo smo naredili obojestransko, pri bolnici z nevrofibromatozo pa enostransko dekompresijo očnice. Endoskopsko smo pri eni bolnici iz očnice odstranili hemangiom, pri enem bolniku pa na ta način potrdili zasevke raka jeter. Rezultati. Pri endoskopskih posegih v predelu očnic in po njih ni bilo zapletov. Po drenažah ognojkov in hematoma se je stanje normaliziralo v 24 urah po posegu. Po endoskopski dekompresiji očnic se je eksoftalmus zmanjšal povprečno za 2 mm. Bolnica šest let po odstranitvi hemangioma iz očnice nima težav. Bolnik je bil po endoskopski potrditvi zasevkov v očnici lokalno obsevan. Zaključki. Endoskopska kirurška tehnika omogoča ciljan pristop do bolezenskih procesov predvsem vzdolž spodnjega in medialnega predela očnic. Pri načrtovanju endoskopskih posegov je pomembno sodelovanje rinokirurga z oftalmologom in rentgenologom. Z endoskopskimi posegi v predelu očnic bistveno manj prizadenemo bolnika, potek po operaciji je manj neprijeten kot po klasičnih posegih, čas bolnišničnega zdravljenja krajši in po posegu ni vidnih brazgotin.
Deskriptorji		ORBITAL DISEASES SURGERY, ENDOSCOPIC PATIENT SELECTION TREATMENT OUTCOME HOSPITALIZATION POSTOPERATIVE COMPLICATIONS CICATRIX SINUSITIS ABSCESS HEMATOMETRA ORBITAL NEOPLASMS