Endoscopic assistance in deep lateral orbital wall decompression

Grusha Y.O.; Dzamikhov I.K.

doi:https://doi.org/10.17116/oftalma202514105123

Grusha Y.O.

I.M. Sechenov First Moscow State Medical University (Sechenov University);
Krasnov Research Institute of Eye Diseases

ORCID: 0000-0002-6461-8243

Dzamikhov I.K.

Krasnov Research Institute of Eye Diseases

ORCID: 0000-0002-9952-9064

Endoscopic assistance in deep lateral orbital wall decompression

Authors:

Grusha Y.O., Dzamikhov I.K.

More about the authors

Journal: Russian Annals of Ophthalmology. 2025;141(5): 23‑28

DOI: 10.17116/oftalma202514105123

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To cite this article:

Grusha YO, Dzamikhov IK. Endoscopic assistance in deep lateral orbital wall decompression. Russian Annals of Ophthalmology. 2025;141(5):23‑28. (In Russ.)
https://doi.org/10.17116/oftalma202514105123

Подписка 2026 Вестник офтальмологии (Russian Annals of Ophthalmology)

Использование инфографики авторами научных работ

OBJECTIVE

This study was conducted to develop a technique for endoscopic assistance during deep lateral orbital bone decompression.

MATERIAL AND METHODS

The study included 349 patients (603 orbits) with thyroid-associated ophthalmopathy (225 women and 124 men, mean age 42.6±11.3 years) who underwent endoscopic-assisted deep lateral wall decompression (DLWD) at the M.M. Krasnov Research Institute of Eye Diseases.

RESULTS

Near-maximum depth of osteodestruction in the deep portion of the lateral wall (LW) of the orbit in the projection of the lateral rectus muscle was achieved in 256 patients (442 orbits). In 290 of these orbits, slight prominence of semi-transparent thinned cortical plates under the influence of the underlying dura mater (DM) was observed. In 19 cases, reaching the cortical layer of the greater wing of the sphenoid bone adjacent to the DM was indicated by the appearance of thin cortical fragments in the projection of the middle cranial fossa oriented at an acute angle to the bone defect; in 5 of these cases, cortical fragments occupied almost the entire orbital surface of the sphenoid trigone (ST). Additionally, exposure of the DM occurred in 49 cases during deep DLWD. One of the anatomical variants of the orbital vascular system found in 75 orbits was a vascular branch within the ST, which topographically corresponded to the course of the anastomosis between a. meningea media and a. lacrimalis.

CONCLUSION

The obtained results indicate the high importance of endoscopic assistance during critical stages of DLWD, particularly in hard-to-reach areas of the LW, which helps minimize the incidence of intraoperative complications.

Keywords:

thyroid-associated ophthalmopathy

thyroid eye disease

bony orbital decompression

lateral orbital wall

endoscopy

Authors:

Grusha Y.O.

I.M. Sechenov First Moscow State Medical University (Sechenov University);
Krasnov Research Institute of Eye Diseases

ORCID: 0000-0002-6461-8243

Dzamikhov I.K.

Krasnov Research Institute of Eye Diseases

ORCID: 0000-0002-9952-9064

Received:

22.01.2025

Accepted:

13.03.2025

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References:

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