Abstract ID: 26-142
Maximal deep lateral orbital decompression with dura exposure
Author: Arnaud Martel Base Hospital / Institution: Ophthalmology department, University Hospital of Nice, France
Presentation Type: Video Presentation
Purpose
To describe the surgical technique, anatomical landmarks, and intraoperative management of maximized lateral wall orbital decompression with intentional dural exposure, performed under neuronavigation guidance.
Methods
Surgical video. Lateral orbitotomy was performed via a lateral canthotomy approach. Neuronavigation (Stryker, Kalamazoo, USA) was used for real-time intraoperative localization of key anatomical structures, including the orbital apex, the sphenoid wing, the temporal lobe dura mater, and the middle cranial fossa
Results
Maximized lateral wall removal included resection of the greater wing of the sphenoid down to the dura mater of the middle cranial fossa, achieving maximum orbital volume expansion.Dural exposure was intentionally achieved without violation of the dural layer. Associated risks included cerebrospinal fluid leak in case of dural tear, temporal lobe injury, intraorbital hematoma, damage to the lacrimal gland, and transient diplopia related to lateral rectus manipulation.
Conclusion
Maximized lateral wall decompression with dural exposure is a safe and effective procedure when performed under neuronavigation guidance. Precise knowledge of the anatomical relationships between the orbital walls, the sphenoid wing, and the middle cranial fossa dura is essential to minimize the risk of intracranial complications and maximize the decompressive effect.