gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Pterional orbital decompression in orbital haemorrhage and trauma

Die pterionale Orbitadekompression bei Blutungen und Traumen der Orbita

Meeting Abstract

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  • corresponding author M.C. Korinth - Neurochirurgische Klinik, Universitätsklinikum der RWTH, Aachen
  • A. Boström - Neurochirurgische Klinik, Universitätsklinikum der RWTH, Aachen
  • J.M. Gilsbach - Neurochirurgische Klinik, Universitätsklinikum der RWTH, Aachen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSA.09.07

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Korinth et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Orbital haemorrhage and trauma are uncommon and may occur either after various orbital and sinus surgery or injections, or after minor or severe head injury with or without facial fractures. If not detected early and treated appropriately, it can lead to devastating loss of vision. Typical findings may be overlooked, especially in patients with multiple injuries or patients with reduced level of consciousness. Several approaches and operative techniques have been described, with variable success and side effects.

Methods: Fifteen patients, showing symptomatic retrobulbar haematoma or symptoms of orbital injury after various trauma mechanisms, were treated with deep lateral orbital decompression and removal of orbital blood/bone fragments via this approach. Preoperative and postoperative course, neuroradiologic findings, additional brain or facial injuries, and outcome of the eye function were analyzed in detail.

Results: Mean delay between trauma and decompression was 70 hours (3 days), with a range from 2 hours to 15 days. Proptosis decreased in all patients and visual acuity improved or remained normal in nine patients and stayed defective in four. Impaired extraocular movements and pupillary changes recovered in 10 patients. Apart from one case of permanent deficit of the frontal branch of the facial nerve, no severe complications were seen.

Conclusions: The presented pterional orbital decompression represents an effective alternative approach for patients with sight-threatening retrobulbar haematoma or orbital trauma, especially in cases that require direct access to damaged structures and maximal decompression of the orbit. Immediate detection and treatment of orbital haematoma is mandatory for acceptable outcome of the eye.