Orbital DEcompression Usiing Caruncular Approach

ABSTRACT

It is important to perform orbital decompression in the manner of minimizing complication and getting good decompressive effect especially in the patients having cosmetic reason, In order to evaluate the effect of the orbital decompression using caruncular approach, we retrospectively analyzed the cases of orbital decompression performed from February 1994 to August 1997. Forty orbits of 22 patients who had been followed 5 months or more were included in the study. The medial wall was decompressed in all cases and the decompression of medial part of inferior wall, or lateral wall. or medial part of inferior and lateral wall was added to the surgical procedure according to the conditions of each case. Exophthalmos was corrected postoperatively by 3mm in the decompression of the medial wall, 4.3mm in the medial and half of inferior walls, 3.7mm in the medial and lateral walls, and 5.5mm in the medial, half of inferior, and lateral walls. Diplopia developed in 13 cases as a complication. Seven of them had to have strabismus surgery and recovered considerably, and the rest of them having diplopia only in extreme lateral gaze had no discomfort in usual activity. We could obtain satisfactory results in all patients, and this caruncular approach might be considered to be the one of the best approaches in orbital decompressions of cosmetic purpose.