1 There is, however, considerable room for orbital expansion in the lateral part of the orbit if the thicker, deep areas of lateral wall are removed. Traditional lateral orbital decompression involves removal of the anterior portion of the lateral orbital wall and is limited in the degree of orbital expansion that can be achieved. ORBITAL decompression surgery is indicated in Graves orbitopathy for optic nerve compression, corneal exposure, disfiguring proptosis, and compressive orbitopathy. There was, however, a significant amount of interpatient variability, especially for the door jamb region.Ĭonclusion Orbital decompression surgery of the deep lateral wall can provide adequate volume expansion because of the amount and location of potential space that exists in the 3 areas of deep bone. The 3 areas of bone contributed variably to the total, with the door jamb contributing the most volume of the 3, nearly twice the value of the other 2. Results The average volumes of the basin of the inferior orbital fissure, the sphenoid door jamb, the lacrimal keyhole, and the total of the 3 regions were 1.2, 2.9, 1.5, and 5.6 cm 3, respectively. A 3-dimensional computer reconstruction of an orbital computed tomographic scan was created, and the 3 areas of potential bone were delineated within it. ![]() We also calculated the volume of bone that could be removed from 11 normal orbits. By means of digitized computed tomographic scans, these 3 areas of bone were analyzed by measuring preoperative and postoperative orbital volumes and predicted bony expansion volumes in 9 patients (17 orbits) who underwent deep lateral orbital decompression surgery. Objectives To calculate the volume of bone in 3 areas of the deep lateral orbit that are available for removal in decompression surgery and to demonstrate these 3 areas within a 3-dimensional computed tomographic reconstruction of the orbit.ĭesign The 3 areas of bone in the deep lateral orbit were designated the lacrimal keyhole, the sphenoid door jamb, and the basin of the inferior orbital fissure. ![]() Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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