Surgical treatment of thyroid ophthalmopathy

tiallyby oculomuscular hypertrophy. This hypertrophy is responsiblefor intraorbital hyperpressure by blocking the veno-lymphaticdrainage at the orbital apex. In most cases, chronic nasal obstructionis responsible for, or accentuates, chronic oedema of soft orbitaltissue. Orbital fat presents slight modifications. Among the numerousoperative techniques for orbital decompression, Tessier’s procedure(malar valgisation by osteotomy and anterior orbital decompression)is effective on proptosis, optic neuropathy and sometimeson strabism. This technique, interesting for its low morbidity, allowsto preserve the integrity of orbital fat and orbital functionalunit.The success of the surgical anterior orbital decompression dependson several factors :- quality of periosteal and orbital decompression ;- oculomotor muscles volume ;- eyeball volume ;- importance of the intraorbital residual veno-lymphatic hyperpressure;- presence of facial retrusion by hypoplasia and on the- quality of the nasal ventilation.