Certain cases of thyroid-related orbitopathy may require surgical decompression of the orbit. The purpose of this paper is to highlight new techniques of orbital decompression in thyroid-related orbitopathy. We present two illustrative cases selected from our recent surgical experience. The techniques of combined-approach decompression, transcaruncular approach to the medial orbital wall, drilling reduction of the greater wing of sphenoid and lateral wall lag-screw fixation after lateralization by greenstick fracture are presented. The relative utility of each technique is examined. These techniques expand the surgical repertoire for this condition and allow individualization of treatment for a specific patient’s needs.
For a number of years, transantral orbital decompression formed the mainstay of surgical treatment of thyroid-related orbitopathy. The goal of this and several subsequently-described operations was to increase orbital volume at the selective expense of the bony orbital walls and, often, the adjacent paranasal sinuses.
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