Temporal Fossa Orbital Decompression for Treatment of Disfiguring Thyroid-Related Orbitopathy

ObjectiveTo describe a technique for treating disfiguring thyroid-related orbitopathy by bony decompression into the temporal fossa and to analyze results.DesignRetrospective, noncomparative case series with description of a surgical technique.ParticipantsThirty-three consecutive patients with disfiguring thyroid-related orbitopathy undergoing decompression into the temporal fossa with the described technique.InterventionReduction in exophthalmos by removal of the lateral orbital wall and the greater sphenoid wing using an eyelid crease approach.Main Outcome MeasuresAmount of reduction in exophthalmos after surgery and incidence of induced postoperative diplopia.ResultsThe average reduction in exophthalmos was 4.51 mm (range, 3–6 mm; standard deviation, ±0.95 mm). New-onset postoperative diplopia was observed in 1 patient.ConclusionsBony decompression of the orbit into the temporal fossa via an eyelid crease approach is an effective treatment for disfigurement in patients with thyroid-related orbitopathy and no preoperative diplopia.Financial Disclosure(s)The authors have no proprietary or commercial interest in any materials discussed in this article.