To evaluate the use of stereotactic navigation during orbital decompression surgery.

We conducted a retrospective analysis of 27 patients (48 orbits) with thyroid-associated orbitopathy who underwent orbital decompression. Stereotactic navigation was performed on 28 orbits of 15 patients, and orbital decompression surgery without navigation was performed on 20 orbits of 12 patients. The changes in medial wall, lateral wall and inferior wall orbital volume in CT scans and horizontal and vertical eyeball deviation after surgery were analyzed in the 2 patient groups.

The mean decompressed volume of orbits was significantly increased in the lateral wall decompression with stereotactic navigation patient group than without stereotactic navigation ( p < 0.05, p = 0.025). However, in the inferior wall and the medial wall decompression, there was no significant difference between the 2 groups. The changes of horizontal and vertical deviation were not significant between the 2 groups and no patient experienced neural damage.

The stereotactic navigation during lateral orbital wall decompression is a safe and effective method for inducing greater decompressed volume.