Right Orbital Floor Decompression
This is Richard Allen at the University of Iowa. This video demonstrates the approach to the orbital floor in an orbital floor decompression.
4-0 silk sutures are placed through the right lower lid.
A lateral canthotomy and inferior cantholysis are performed followed by a transconjunctival incision just inferior to the inferior boarder of the tarsus.
Dissection is then performed between the orbicularis muscle and the orbital septum with the monopolar cautery.
This dissection is carried out inferiorly to the inferior orbital rim.
It is useful to visualize the fat pads beneath the septum so that the correct plane can be identified.
4-0 Silk sutures are then placed through the edge of the conjunctiva to provide traction during the dissection.
Dissection is continued in the direction of the inferior orbital rim.
The malleable retractor is then placed and the inferior orbital rim is identified.
The periosteum is then incised and the elevated from the orbital floor.
Depending on the goal of the decompression, varying amounts of bone can be removed to adequately decompress the orbit in conjunction with a medial and/or lateral decompression.