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Updated: Mar 14, 2026

Full-Endoscopic Interlaminar Approach for Decompression of Lateral Recess Stenosis
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Open versus endoscopic medial orbital decompression: Utilization, cost, and operating room time.

Elisabeth H Ference1, Raj Sindwani, Bruce K Tan

  • 1Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

American Journal of Rhinology & Allergy
|September 23, 2016
PubMed
Summary

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Endoscopic orbital decompression, used in 22.9% of cases, varied by location and reason. While open procedures had shorter operating room times, costs were similar between endoscopic and open decompression techniques.

Area of Science:

  • Ophthalmology
  • Rhinology
  • Surgical Innovation

Background:

  • Endoscopic sinus surgery has advanced rhinology and ophthalmology, enabling new approaches to orbital and optic nerve decompression.
  • Understanding the utilization and outcomes of open versus endoscopic medial orbital decompression is crucial for optimizing patient care.

Purpose of the Study:

  • To analyze the geographical and indication-based utilization of open versus endoscopic medial orbital decompression.
  • To describe patient demographics undergoing these distinct surgical techniques.
  • To compare procedural outcomes, including mean charges and operating room (OR) times.

Main Methods:

  • Extraction of de-identified case data from state ambulatory surgery databases (California, Florida, Maryland, New York) between 2009-2011.

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  • Identification of cases using Current Procedural Terminology (CPT) codes.
  • Comparative analysis of patient demographics, diagnoses, mean charges, and OR times between open and endoscopic decompression.

    • Main Results:

    • A total of 1009 patients underwent orbital decompression; 93.0% involved the medial wall.
    • Endoscopic decompression was utilized in 22.9% of medial wall cases, with open techniques used in 74.5%.
    • Endoscopic decompression was more likely for infection-related surgeries (OR 5.27) and in Florida compared to California. Multivariate analysis showed a significant difference in median charges (p=0.04) favoring open procedures, while OR times were not significantly different after controlling for covariables.

    Conclusions:

    • Endoscopic orbital decompression shows significant variation in use based on geography and indication.
    • While open procedures demonstrated shorter OR times on bivariate analysis, multivariate analysis revealed no significant difference in charges or OR times between endoscopic and open techniques.
    • Further investigation is warranted to determine the relative effectiveness of open versus endoscopic surgical approaches for diverse indications in orbital decompression.