Endoscopic Orbital Decompression Under Local Anesthesia

Survey

Indications:

  • Orbital decompression in an only-seeing eye
  • Grave‚Äôs 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.