Goldberg RA, Gout T. Orbital Decompression: Conceptual Approach for Orbital Volume Expansion.
Ophthalmic Plast Reconstr Surg 2023;
39:S105-S111. [PMID:
38054990 DOI:
10.1097/iop.0000000000002556]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
PURPOSE
To review the advances in the surgical techniques of orbital decompression.
METHODS
A literature review of orbital decompression surgery and experience-based consideration of bony areas for decompression.
RESULTS
In the 100-year-plus span of orbital decompression literature, multiple incisions and multiple bone and fat removal strategies have been described. In general, bone removal has been conceptualized as consisting of 4 walls of the orbit. However, the orbital bony anatomy is more subtle than a simple box, and considering 6 areas of potential bony removal allows a more nuanced paradigm for clinical decision-making and for understanding various technique descriptions. Historical and current techniques, and surgical planning and decision-making, are described from the perspective of a 6 area paradigm. Potential complications are reviewed.
CONCLUSION
A conceptual framework for orbital decompression focusing on 6 potential areas of bone removal provides a nuanced and flexible paradigm for understanding and describing surgical techniques, and for designing individualized surgery. Orbital decompression surgery should be customized to the patient's anatomy and symptoms.
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