Endoscopic Orbital Decompression

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Abstract

For more than 100 years, surgical decompression of the orbit has been used to treat severe proptosis and thyroid eye disease, also known as Graves ophthalmopathy. With the advent of endoscopic sinus surgery in the mid-1980s, otolaryngologists began experimenting with endoscopic orbital surgery, with the first descriptions by Kennedy et al. and Michel et al. arriving soon thereafter in the early 1990s. With enhanced visualization and improvement in instrumentation, safe and thorough decompression of the medial orbital wall and orbital floor can be achieved without external approaches. An excellent understanding of sinonasal anatomy and landmarks, as well as proficiency with endoscopic sinus surgery, is a prerequisite for performing this procedure safely. Moreover, a team-based approach with ophthalmology will not only strengthen the otolaryngologist’s ability to perform this procedure safely but also know the limitations of this approach and when it is appropriate to combine this approach with a lateral or superior decompression. Endoscopic orbital decompression also provides a stepping stone for the skills required to perform transnasal endoscopic orbital surgery in the appropriate setting, as well as an understanding of the complications related to endoscopic orbital surgery and appropriate management strategies.

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Lobo, B. C., & Sindwani, R. (2018). Endoscopic Orbital Decompression. In Atlas of Endoscopic Sinus and Skull Base Surgery, Second Edition (pp. 149-156.e1). Elsevier. https://doi.org/10.1016/B978-0-323-47664-5.00018-3

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