Endoscopic Orbital Decompression Under Local Anesthesia
Indications:
- Orbital decompression in an only-seeing eye
- Grave’s orbitopathy
Highlights:
- Injection of local anesthetic
- Sphenoethmoidectomy to fully expose the lamina papyracea
- Maxillary antrostomy should be large for adequate exposure of orbital floor
- Removal of lamina papyracea
- Incise periorbita from posterior to anterior so that view is not obscured as orbital fat prolapses into nasal cavity
Keep in Mind/Things to Remember:
- Additional infiltration of local anesthesia may be necessary just prior to incision of periorbita
- Avoid bone removal in region of frontal recess so as not to obstruct frontal outflow from prolapsing orbital fat.