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Endoscopic Orbital Decompression: Technical Pearls and Pitfalls of an Evolving Technique
- Source :
- American journal of rhinologyallergy. 35(4)
- Publication Year :
- 2020
-
Abstract
- Background First described in the early 1990s, endoscopic orbital decompression has become increasingly popular and has been shown to be a safe and effective approach for surgical decompression of the medial and inferior orbit. Methods We present our preferred technique for performing an endoscopic orbital decompression, highlighting key pearls and pitfalls. Results An endoscopic wide maxillary antrostomy and sphenoethmoidectomy is performed in standard fashion. We prefer to resect the middle turbinate for optimal exposure and access. The medial orbital wall is skeletonized and the lamina papyracea is carefully elevated, preserving the underlying periorbita. The orbital floor medial to the infraorbital nerve is resected. Once the periorbita is fully exposed, parallel axial incisions along the medial orbit and orbital floor are made from posterior to anterior using a sickle knife, taking care not to bury the tip to avoid injuring underlying orbital contents. The remaining fibrous bands are incised and prolapse of orbital fat is observed. Post extubation bag mask ventilation is limited to avoid subcutaneous emphysema. Conclusion Compared to open techniques, endoscopic orbital decompression provides superior visualization of critical anatomical landmarks, assures healthy sinus functioning post procedure, offers a lower complication rate, and avoids external incisions.
- Subjects :
- 2019-20 coronavirus outbreak
Medial orbital wall
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19)
business.industry
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Orbital decompression
Endoscopy
General Medicine
Decompression, Surgical
eye diseases
03 medical and health sciences
Surgical decompression
0302 clinical medicine
030228 respiratory system
Otorhinolaryngology
Immunology and Allergy
Medicine
Humans
Radiology
030223 otorhinolaryngology
business
Image guidance
Orbit
Orbital apex
Subjects
Details
- ISSN :
- 19458932
- Volume :
- 35
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- American journal of rhinologyallergy
- Accession number :
- edsair.doi.dedup.....6cd00edd8654bb33dbf8d89a9f56934b