Endoscopic orbital decompression

The effectiveness of orbital decompression has been enhanced by the use of endoscopes in orbital decompressive surgery. In patients with severe proptosis and visual compromise, surgical intervention provides definitive therapy. Endoscopes have allowed for more complete removal of the bone posteriorly to the orbital apex under direct visualization, which has led to a decrease in morbidity. Two-wall decompression is now the minimum procedure that successfully achieves release of contents at the orbital apex. Whether the endoscope is used as an adjunct surgically or postoperatively to facilitate debridement, it has become an important tool in the armamentarium for the successful management of proptosis. The endoscopic view of posterior ethmoidal sinuses and the sphenoid sinuses enables the surgeon to successfully carry out a posterior decompression, and provides the opportunity to decompress the optic nerve if the need arises.