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.