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.