Orbital decompression for thyroid eye disease.

Area of Science:

• Ophthalmology
• Neurosurgery
• Head and Neck Surgery
• Maxillofacial Surgery

Background:

• Thyroid eye disease often necessitates orbital decompression surgery.
• Over 100 years of surgical advancements have yielded numerous techniques.
• Existing literature presents a wide array of minor technical variations.

Purpose of the Study:

• To systematically review and organize the four major orbital decompression approaches.
• To provide a conceptual framework for understanding transdisciplinary surgical techniques.
• To relate surgical variations to underlying bony orbital anatomy.

Main Methods:

• Comprehensive literature review of orbital decompression techniques.
• Categorization of surgical approaches based on anatomical entry points (transorbital, transcranial, transantral, transnasal).
• Analysis of technique variations within the context of major approaches and bony anatomy.

Main Results:

• Identified four primary surgical approaches to orbital decompression.
• Demonstrated that most literature variations are modifications of these core techniques.
• Highlighted the importance of bony anatomy in understanding procedural differences.

Conclusions:

• Orbital decompression techniques, despite variations, can be understood through four major anatomical approaches.
• A unified conceptualization based on bony anatomy aids in navigating the extensive literature.
• This review provides a structured overview for surgeons across specialties involved in orbital decompression.