{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T13:12:03Z","timestamp":1779887523003,"version":"3.53.1"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2016,3,1]],"date-time":"2016-03-01T00:00:00Z","timestamp":1456790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Postoperative diplopia occurs in up to 45% of patients following orbital decompression for exophthalmos associated with Graves\u2019 orbitopathy. We sought to describe outcomes of our balanced orbital decompression strategy that includes the preservation of a modified inferomedial orbital strut (mIOS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Academic medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>A total of 115 consecutive orbital decompressions were performed on 73 patients (42 bilateral) with Graves\u2019 orbitopathy. All patients underwent (1) a balanced decompression technique incorporating an endoscopic medial and external lateral decompression and (2) a mIOS technique with preservation of the anterior half of the inferomedial orbital strut. A periorbital periosteal (orbital) sling was utilized in patients (n = 54) without threatened vision loss, proptosis &gt;28\u00a0mm, or periorbital disruption to prevent prolapse of the medial rectus muscle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Utilization of the mIOS technique with or without a sling did not adversely affect the reduction in proptosis (5.1\u00a0mm with sling vs 5.0\u00a0mm without sling; <jats:italic>P<\/jats:italic> =. 85).The incidence of new\u2010onset postoperative diplopia was 17% (n = 6). The sling was not associated with postoperative diplopia (odds ratio = 0.54, 95% confidence interval: 0.08\u20103.40, <jats:italic>P<\/jats:italic> =. 51), while it was associated with resolution of preexisting diplopia (odds ratio = 6.67, 95% confidence interval: 1.06\u201042.06, <jats:italic>P<\/jats:italic> =. 04). No intraoperative complications occurred, and no patients suffered a decrement in visual acuity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Balanced orbital decompression utilizing a mIOS in patients with Graves\u2019 orbitopathy provides a safe and effective reduction in proptosis with a low rate of new\u2010onset diplopia as compared with historical values. Utilization of an orbital sling may be beneficial in reducing postoperative diplopia in select patients.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599816630722","type":"journal-article","created":{"date-parts":[[2016,3,1]],"date-time":"2016-03-01T22:13:59Z","timestamp":1456870439000},"page":"963-969","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Orbital Decompression in the Endoscopic Age"],"prefix":"10.1002","volume":"154","author":[{"given":"William C.","family":"Yao","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology University of Texas Medical School at Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad R.","family":"Sedaghat","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts USA"},{"name":"Department of Otology and Laryngology Harvard Medical School 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