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

Objective: To describe a technique for treating disfiguring thyroid-related orbitopathy by bony decompression into the temporal fossa and to analyze results. Design: Retrospective, noncomparative case series with description of a surgical technique. Participants: Thirty-three consecutive patients with disfiguring thyroid-related orbitopathy undergoing decompression into the temporal fossa with the described technique. Intervention: Reduction in exophthalmos by removal of the lateral orbital wall and the greater sphenoid wing using an eyelid crease approach. Main Outcome Measures: Amount of reduction in exophthalmos after surgery and incidence of induced postoperative diplopia. Results: 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. Conclusions: 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. Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article.