OPERATIVE CONTROL OF PROGRESSIVE EXOPHTHALMOS

Author:
  • ESEdward Cecil Sewall
    Edward Cecil Sewall
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Abstract
Progressive exophthalmos is a serious disorder. It is not always controlled by surgical or other therapy directed toward the thyroid. It may cause blindness from involvement of the optic nerve and the background or from ulceration of the cornea and eventual ophthalmitis. The problem presented is caused by an increase in the bulk of the orbital content beyond the capacity of the orbit itself. Naffziger and Jones1explained the increase in bulk and have met the problem by a decompression operation. They expressed the belief that the increase in bulk is essentially due to changes that increase the thickness of the ocular muscles to many times their natural size. Their histologic sections confirm this opinion. Their method consists of entering the skull in the frontal region, elevating the dura and the frontal lobe of the brain, removing the bony roof of the orbit, avoiding the sinuses, enlarging the optic