Endoscopic orbital floor decompression with preservation of the inferomedial strut

Medial and inferior orbital decompression is most commonly performed in the setting of dysthyroid orbitopathy. Diplopia represents the most common complication and may be minimized through the preservation of a bony inferomedial strut (IMS). Historically, this has required a transconjunctival approach due to the technical demands of performing an isolated orbital floor decompression using endoscopic instrumentation. Here we describe a novel technique of a purely endoscopic orbital floor decompression with reliable preservation of the IMS.

[1]  M. Jiménez-Chobillon,et al.  Transnasal endoscopic approach in the treatment of Graves ophthalmopathy: the value of a medial periorbital strip. , 2010, European annals of otorhinolaryngology, head and neck diseases.

[2]  S. Leong,et al.  Outcomes following surgical decompression for dysthyroid orbitopathy (Graves' disease) , 2010, Current opinion in otolaryngology & head and neck surgery.

[3]  S. Leong,et al.  A systematic review of outcomes following surgical decompression for dysthyroid orbitopathy , 2009, The Laryngoscope.

[4]  C. MacEwen,et al.  Endoscopic orbital decompression for dyscosmetic thyroid eye disease , 2007, The Journal of Laryngology & Otology.

[5]  R. Dailey,et al.  Customized, Single-Incision, Three-Wall Orbital Decompression , 2005, Ophthalmic plastic and reconstructive surgery.

[6]  R. Metson,et al.  Reduction of Diplopia Following Endoscopic Orbital Decompression: The Orbital Sling Technique , 2002, The Laryngoscope.

[7]  M. Desrosiers,et al.  Endoscopic orbital decompression with preservation of an inferomedial bony strut: minimization of postoperative diplopia. , 1999, The Journal of otolaryngology.

[8]  R. Goldberg,et al.  The Medial Orbital Strut in the Prevention of Postdecompression Dystopia in Dysthyroid Ophthalmopathy , 1992, Ophthalmic plastic and reconstructive surgery.

[9]  S. Zinreich,et al.  Endoscopic transnasal orbital decompression. , 1990, Archives of otolaryngology--head & neck surgery.

[10]  P. M. Stell Transantral Orbital Decompression in Malignant Exophthalmos , 1968, The Journal of Laryngology & Otology.

[11]  J. Dollinger Die Druckentlastung der Augenhöhle durch Entfernung der äußeren Orbitalwand bei hochgradigem Exophthalmus (Morbus Basedowii) und konsekutiver Hornhauterkrankung , 1911 .