The Removal of the Deep Lateral Wall in Orbital Decompression: Its Contribution to Exophthalmos Reduction and Influence on Consecutive Diplopia

The application of stereotactic navigation surgery to orbital decompression for thyroid-associated orbitopathy

“…15 The advantages of deep bony decompression posterior to the lateral orbital rim are (i) less postoperative morbidity; (ii) when approached from the internal aspect, temporalis muscle trauma is minimized, reducing the risks of secondary muscle atrophy, potential for haemorrhage and chewing difficulty; and (iii) it is a faster technique. 33 We believe that maximizing bone removal allows for less need for orbital fat removal, and minimizing direct injury to the lateral recti muscle and the potential for nerve damage. This may be the reason for no new onset diplopia using this technique.…”

“…The contribution of the posterolateral wall decompression for exophthalmos reduction has been recently shown to be 2.3 mm, as part of a coronal approach, 3-wall decompression without increasing the risk of consecutive diplopia. 33 The ideal bone removal of the lateral wall would include both lateral and deep lateral walls, extending from the roof to the floor, with maximal debulking of the trigone.…”

Consensus statement of the European Group on Graves' orbitopathy (EUGOGO) on management of GO

“…However, orbital decompression can be considered also in patients with active GO who are intolerant or nonresponsive to GCs, if waiting for spontaneous inactivation of GO can potentially be hazardous for visual function. † Almost all studies show the efficacy and relative safety of orbital decompression (46,(94)(95)(96)(97)(98)(99)(100)(101); however, the available studies do not allow any meaningful comparison of the available techniques (93,94,100,101). † Eye muscle and lid surgeries are effective treatments for correcting diplopia and improving lid function and appearance.…”

Minimally Invasive Methods of Surgical Treatment of Endocrine Ophthalmopathy

“…[12]. Средний по-казатель регресса экзофтальма с применением данной методики соответствует 6 мм, частота развития дипло-пии 7% [13]. Недостатками данного доступа являются ограничение визуализации нижней и медиальной стенок глазницы, что делает невозможным расширение опера-ционного доступа для резекции более чем одной стенки глазницы, а также развитие видимого послеоперацион-ного рубца, что само по себе может вызвать стойкий кос-метический дефект [14].…”