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Surgery in Thyroid Eye Disease pp 111–126Cite as

Orbital Decompression: Approaches to the Orbit and Surgical Planning

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Abstract

There are four components of thyroid eye disease (TED) that require attention from the surgical point of view: proptosis, restrictive strabismus, eyelid abnormality (retraction), and cosmetic concerns (fat bags, rhytids, etc.). Based on these four components, the surgical management of TED involves four major stages of rehabilitation: orbital decompression, extraocular muscle surgery, eyelid repositioning, and cosmetic soft tissue redraping [1]. Not all patients require all four stages, but one may require more than one stage of surgery. Proptosis is one of the most visible and obvious side effects of TED that demands treatment. Historically, the inferior and medial walls were removed by the otorhinolaryngologists; and the deep lateral wall by the neurosurgeons. The transantral approach created unbalanced inferomedial decompression with a high incidence of consecutive strabismus, infraorbital anesthesia, and sinusitis [2, 3]. The fourth wall, orbital roof decompression was initially advocated by Naffziger, but is fraught with potentially serious complications, and hence is best avoided except in extreme cases.

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Authors and Affiliations

  1. Ophthalmic Plastic Surgery Service, LV Prasad Eye Institute, Hyderabad, India

    Milind N. Naik

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  1. Milind N. Naik
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Correspondence to Milind N. Naik .

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  1. Ophthalmic Plastic Surgery Service, LV Prasad Eye Institute, Bhubaneswar, India

    Suryasnata Rath

  2. Ophthalmic Plastic Surgery Service, LV Prasad Eye Institute, Hyderabad, India

    Milind N. Naik

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Naik, M.N. (2020). Orbital Decompression: Approaches to the Orbit and Surgical Planning. In: Rath, S., Naik, M. (eds) Surgery in Thyroid Eye Disease. Springer, Singapore. https://doi.org/10.1007/978-981-32-9220-8_9

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  • DOI: https://doi.org/10.1007/978-981-32-9220-8_9

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