Balanced Orbital Decompression Technique

Balanced medial plus lateral wall orbital decompression was performed by two of the authors (Mei Wang and Peng Tian). Image-guidance (Fusion Navigation, Medtronic Inc., Jacksonville, FL) was applied to all eyes. Lateral wall orbital decompression was performed much the same as previously reported by an ophthalmologist (Mei Wang) using an eyelid crease incision [14 (link)]. The greater wing of the sphenoid bone was removed, and additional removal of the anterior department of the inferior orbital fissure was performed in most patients. Medial wall orbital decompression was performed much the same as previously described by an otolaryngologist (Peng Tian) using a transnasal endoscopic approach [15 (link)]. The procedures were as follows: (1) incise and excise the uncinate process. (2) The ethmoid sinus was fully opened, and the lamina papyracea was exposed synchronously. (3) The apertures of the sphenoid sinus and maxillary sinus were adequately opened to prevent inflammation of the sinus cavity. (4) Excision of the lamina papyracea was conducted as much as possible. (5) The periosteum and orbital fascia were cut open to bring about a bulge of orbital fat.