Frontal osteoplastic flap without frontal sinus obliteration for orbital roof decompression. (4th March 2021)

• Record Type: Journal Article
• Authors: Kim, Matthew; Otten, Marc; Kazim, Michael; Gudis, David A.
• Is Part Of: Orbit. Volume 40:Number 2(2021)
• Page Start: 145
• Page End: 149
• Publication Date: 2021-03-04
• Subjects: Endonasal orbital surgery -- endoscopic orbital surgery -- frontal fibro-osseous lesions -- frontal fibrous dysplasia -- frontal osteoma -- orbital roof decompression; Eye-sockets -- Surgery -- Periodicals; Eye-sockets -- Diseases -- Periodicals; Orbit -- surgery -- Periodicals; Orbital Diseases -- Periodicals; 617.7
• DOI: 10.1080/01676830.2020.1757126
• Languages: English
• ISSNs: 0167-6830

Abstract

ABSTRACT: Purpose : We describe a novel surgical approach for bilateral orbital roof decompression using a frontal osteoplastic flap without frontal sinus obliteration. This technique utilizes a combined external and endonasal endoscopic approach for wide exposure to the orbital roof bilaterally. We demonstrate this technique for the resection of a massive frontal fibrous dysplasia lesion in a healthy male with bilateral orbital roof involvement. The endonasal endoscopic portion of the technique includes a Draf III frontal sinusotomy (endoscopic modified Lothrop procedure) which precludes the need for frontal sinus obliteration, restores normal frontal sinus function, and allows for postoperative endoscopic surveillance. Methods : Report of novel surgical technique with video demonstration. Results : This technique for orbital roof decompression allows for removal of a frontal lesion, wide decompression of the bilateral orbital roof, and post-operative endonasal endoscopic surveillance of the cavity. The patient in whom we demonstrate this technique had complete resolution of his orbital symptoms and minimal residual fibrous dysplasia postoperatively. Conclusion : Bilateral orbital roof decompression for frontal lesions can be performed safely and effectively with a frontal osteoplastic flap without frontal sinus obliteration, restoring normal orbital and sinus function.