A Safer and Easier Method to Open the Orbital Septum: Septal Ballooning

To introduce a novel septal ballooning technique for orbital septum dissection during surgery.

The study comprised 18 patients (30 eyes) who underwent septal ballooning at Gachon Gil Hospital, Incheon, South Korea, between September 2023 and January 2024. The technique involves injecting room air beneath the orbital septum, a pneumodissection, to separate it from surrounding structures, enhancing visualization during dissection. Data collected included patient demographics, preoperative diagnoses, and postoperative complications. Intraoperative levator aponeurosis injury and postoperative complications were reported.

Septal ballooning was successfully performed on all patients, with no intraoperative injuries to the levator aponeurosis. Postoperative CT imaging revealed minor orbital emphysema in 3 cases (4 eyes), which resolved spontaneously without intervention. There were no reports of significant complications such as visual sequelae or infections. The technique facilitated clear identification and dissection of the orbital septum, reducing intraoperative difficulty.

The septal ballooning technique is an effective alternative method for orbital septum dissection, offering improved anatomical visualization and reduced intraoperative complexity. This method enhances the precision and safety of procedures involving the orbital septum and is a valuable addition to surgical practice.