SURGICAL DECOMPRESSION OF MALIGNANT EXOPHTHALMOS

MALIGNANT exophthalmos¹ is a clinical entity distinct from exophthalmos as generally seen accompanying thyrotoxicosis. These conditions may be closely related etiologically²; yet the diverse clinical pictures they present and the difference in their management make it necessary that the clinician be acquainted with the diagnostic criteria of the disease and the surgeon be familiar with the underlying pathologic process on which the treatment is based.

In this paper I shall enlarge on these facts and introduce a new surgical approach, which I have employed successfully.

HISTORY  Malignant exophthalmos was first seen and described by von Basedow³ in 1840. Since this initial report, 216 cases have been reported in the literature. (Würdemann and Becker,⁴ Lahey,⁵ Moore,⁶ Zimmerman,⁷ Hirsch and Urbanek,⁸ Naffziger and Jones,⁹ Gasteiger,¹⁰ (Footnotes continued on next page) King,¹¹ Semmes,¹² Andersson,¹³ Merrill and Oaks,¹⁴ Bothman,¹⁵ Means,¹⁶ Hertz,¹⁷ Thomas and Woods,¹⁸ Rosenbaum,¹⁹ Stallard,²¹ Lyle,²² Kistner,²³ Ginsburg²⁴ McCravey and Mather,²⁵ Reiching and