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Orbital Decompression: Transnasal and Transethmoid Endoscopic Approaches

  • Howard L. Levine
Chapter

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.

Keywords

Graves’ disease Thyroid ophthalmopathy Endoscopic orbital decompression 

Supplementary material

419986_5_En_51_MOESM1_ESM.mp4 (133.3 mb)
Video 51.1 MicroFrance®—Levine orbital decompression instrument set. Courtesy of Howard Levine and Integra MicroFrance Instruments, Cincinnati, Ohio (MP4 136500 kb)

References

  1. 1.
    Wehrmann D, Antisdel JL. An update on endoscopic orbital decompression. Curr Opin Otolaryngol Head Neck Surg. 2017;25:73.PubMedGoogle Scholar
  2. 2.
    Berhouma M, Jacquesson T, Abouaf L, Vighetto A, Jouanneau E. Endoscopic endonasal optic nerve and orbital apex decompression for nontraumatic optic neuropathy: surgical nuances and review of the literature. Neurosurg Focus. 2014;37:E19.CrossRefPubMedGoogle Scholar
  3. 3.
    Lima WT, Perches M, Valera FC, Demarco RC. Orbital endoscopic decompression in Graves ophthalmopathy. Rev Bras Otorrinolaringol. 2006;72:283.CrossRefGoogle Scholar
  4. 4.
    Metson R, Pletcher SD. Endoscopic orbital and optic nerve decompression. Otolaryngol Clin N Am. 2006;39:943.CrossRefGoogle Scholar
  5. 5.
    Stankiewicz J, Lal D, Connor M, Welch K. Complications in endoscopic sinus surgery for chronic rhinosinusitis: a 25-year experience. Laryngoscope. 2011;121:2684.CrossRefPubMedGoogle Scholar

Additional Suggested Technical Videos

  1. Endoscopic orbital decompression. Courtesy of Sinusvideos.com. https://www.youtube.com/watch?v=6I49KlKwwX0
  2. Endoscopic orbital decompression. Courtesy of Richard Harvey, MD, PhD. https://www.youtube.com/watch?v=vGJN84Ae4e4

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Cleveland Nasal Sinus & Sleep CenterClevelandUSA
  2. 2.Department of OtolaryngologyCleveland Clinic HillcrestClevelandUSA

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