By Kelvin Chong, MD
    Annual Meeting 2011

    This video demonstrates the endoscopic landmarks, techniques, and possible complications of endonasal transethmoidal medial orbital wall decompression for dysthyroid optic neuropathy. After appropriate anesthesia and nasal packing, the uncinate process is removed and a complete anterior and posterior ethmoidectomy is performed. The posterior ethmoidal vessel can often be seen before the entry of the sphenoid sinus. Lamina papyraceous can be peeled completely from the medial wall periosteum and the periosteum opened from posterior to anterior using a crescent blade. Prolapsing orbital fat is gently teased out into the sinus cavity to conclude the operation.