Temporal fossa orbital decompression for treatment of disfiguring thyroid-related orbitopathy.

Abstract

To describe a technique for treating disfiguring thyroid-related orbitopathy by bony decompression into the temporal fossa and to analyze results. Retrospective, noncomparative case series with description of a surgical technique. Thirty-three consecutive patients with disfiguring thyroid-related orbitopathy undergoing decompression into the temporal fossa with the described technique. Reduction in exophthalmos by removal of the lateral orbital wall and the greater sphenoid wing using an eyelid crease approach. Amount of reduction in exophthalmos after surgery and incidence of induced postoperative diplopia. The 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. Bony 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.