Decompression of the Superior Orbital Fissure

Abstract

A 19-year-old youth sustained a head injury which damaged the third and sixth cranial nerves. On June 23, 19SS, 37 days after the accident, de­ compression of these two nerves was undertaken. This case was previously reported.1 The procedure consisted of complete removal of the mucosal lining of the frontal, ethmoidal and sphenoidal sinuses on the affected side. Then the roof of the orbit was elevated from the mesial side so as to reach the superior and lateral borders of the superior orbital fissure. Downward traction of the orbit by the Niho brain elevator revealed the upper portion of the superior orbital fissure. Bleed­ ing was controlled by gentle tapping of the ham­ mer and chisel (figs. 1 and 2 ) . Following this pro­ cedure, the lateral rectus regained its normal func­ tion and the lateral motion of the eyeball was re­ stored. Fig. 2 (Murakami). Hammering lateral wall of superior orbital fissure.