With enhanced visualization and improvement in instrumentation, safe and thorough decompression of the medial orbital wall and orbital floor can be achieved without external approaches. An excellent understanding of sinonasal anatomy and landmarks, as well as proficiency with endoscopic sinus surgery, is a prerequisite for performing this procedure safely.

Moreover, a team-based approach with ophthalmology will not only strengthen the otolaryngologist’s ability to perform this procedure safely but also know the limitations of this approach and when it is appropriate to combine this approach with a lateral or superior decompression. Endoscopic orbital decompression also provides a stepping stone for the skills required to perform transnasal endoscopic orbital surgery in the appropriate setting, as well as an understanding of the complications related to endoscopic orbital surgery and appropriate management strategies.