Orbital Decompression: Transnasal and Transethmoid Endoscopic Approaches

Abstract

Graves’ ophthalmopathy can be caused by excessive periorbital fat that puts pressure on the globe and adjacent structures resulting in proptosis, diplopia, and visual loss. The air-filled ethmoid and maxillary sinuses are adjacent to the bony orbit. Upon removal of the common walls between the orbit and these sinuses, there is a space provided into which the periorbital fat can prolapse relieving the intraorbital pressure. Performing the orbital decompression endoscopically through the ethmoid and maxillary sinuses permits a delicate and thorough procedure minimizing risk to important structures within the orbit.