In brief
Endoscopic orbital decompression removes parts of the bony walls of the orbit through the nose to give the orbital tissues more space.
It is indicated mainly in thyroid eye disease with optic nerve compression, corneal exposure or marked proptosis.
Planning is shared between the ophthalmologist and the ENT surgeon.
Endoscopic orbital decompression uses a transnasal approach to selectively remove bony walls of the orbit, mainly the medial wall and, depending on the indication, parts of the floor, creating more space for the orbital tissues.
Indications
One of the main indications is thyroid eye disease (Graves’ orbitopathy), particularly with compressive optic neuropathy, corneal exposure or significant proptosis, according to the phase and clinical picture. Planning is multidisciplinary and involves ophthalmology and ENT expertise.
Why the endoscopic approach
The endonasal route gives a direct view of the medial orbital wall and orbital apex without skin incisions. The extent of decompression is tailored to the clinical goal and can be combined with external approaches in balanced strategies.
Risks and planning
Eye movements and double vision, globe position, the optic nerve, the paranasal sinuses and orbital anatomy must be carefully assessed. As with any orbital surgery, indication and technique are individualised.
See also Lacrimal pathways and orbit.
Reference: Orbital decompression for thyroid eye disease. PubMed
Author: Dr Puya Dehgani-Mobaraki. This information is educational and does not replace a specialist consultation.