scholarly journals Medial Rectus Anastomosis Under Endoscopic Endonasal Orbital Approach With Image-Guided Navigation: A New Way of Repairing a Ruptured Medial Rectus

2019 ◽  
pp. 014556131986960
Author(s):  
Ying-Xing Wu ◽  
Zhi-Yong Li ◽  
Ban Luo ◽  
Xiao-Bo Long ◽  
Nan Xiang ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Muscle Injury ◽  
Professional Training ◽  
Rectus Muscle ◽  
Sinus Surgery ◽  
Medial Rectus ◽  
Endoscopic Endonasal ◽  
Image Guided ◽  
Correct Application ◽  
Orbital Complications

Background: With the extensive development of endoscopic sinus surgery, iatrogenic medial rectus muscle injury should be treated with caution. Traditional methods to repair a ruptured medial rectus need an anterior orbitotomy approach, with more injury and difficulty in finding the posterior end of the ruptured medial rectus. Objective: To explore a new method to repair a ruptured medial rectus. Methods: Eight cases of iatrogenic medial rectus rupture after endoscopic sinus surgery were reviewed from July 2015 to January 2019. Assisted by image-guided navigation, the ruptured medial rectus was sutured under an endoscopic endonasal orbital approach. Two methods were designed to suture the ruptured medial rectus. Optic nerve and orbital decompression were performed in 5 cases with visual impairment. The extent of exotropia and diplopia were followed up for 5 to 33 months after surgery. Results: With the help of image guidance, the posterior and anterior ends of the ruptured medial rectus of all patients were pinpointed, and operations using medial rectus anastomosis were successfully completed in 7 patients. The exotropia of these patients was corrected, and they have recovered. The vision of 2 patients recovered. There were no minor or major complications intraoperatively or postoperatively. Conclusion: Assisted by image-guided navigation, medial rectus anastomosis under an endoscopic endonasal orbital approach is a feasible method. The key to preventing orbital complications is strict professional training, including identification of the Onodi air cell and correct application of powered instrumentation.

Extraocular Muscle Damage Associated with Endoscopic Sinus Surgery: An Ophthalmology Perspective

2005 ◽  
Vol 19 (4) ◽  
pp. 400-405 ◽  
Author(s):  
Neepa M. Thacker ◽  
Federico G. Velez ◽  
Joseph L. Demer ◽  
Marilene B. Wang ◽  
Arthur L. Rosenbaum
Keyword(s):  
Muscle Damage ◽  
Endoscopic Sinus Surgery ◽  
Surgical Procedure ◽  
Extraocular Muscle ◽  
Muscle Injury ◽  
Rectus Muscle ◽  
Sinus Surgery ◽  
Medial Rectus ◽  
Orbital Wall ◽  
Operative Notes

Background Orbital complications associated with endoscopic sinus surgery are well documented. Damage to the medial rectus muscle results in complicated strabismus and disturbing diplopia. The aim of this study was to characterize the types of extraocular muscle injury and the number of muscles involved that may complicate endoscopic sinus surgery and correlate its occurrence to factors in the surgical procedure itself. Methods A retrospective chart review was performed of 14 patients with strabismus after endoscopic sinus surgery. Operative notes of the surgical procedure, pathology reports of the intraoperative specimens, postoperative pattern of strabismus, the extraocular muscle involved, and the type of muscle injury characterized by orbital imaging were reviewed in each patient. Results In our series, not only the medial rectus muscle but also the inferior rectus and the superior oblique muscles were damaged with multiple muscles being involved in one patient. Extraocular muscle injury varied from hematoma, entrapment of muscle in the fractured orbital wall, damage to the oculomotor nerve entry zone, muscle transection, and partial or complete muscle destruction with entrapment in scar tissue. Use of the microdebrider causes extensive irreparable muscle damage. Conclusion Extraocular muscle damage complicating endoscopic sinus surgery can produce therapeutically challenging complicated strabismus.

scholarly journals Extraocular muscle injury during endoscopic sinus surgery: a series of 10 cases at a single center

2014 ◽  
Vol 52 (3) ◽  
pp. 238-245
Author(s):  
J.H. Sohn ◽  
S.D. Hong ◽  
J.H. Kim ◽  
H.-J. Dhong ◽  
S.-K. Chung ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Extraocular Muscle ◽  
Muscle Injury ◽  
Case Series ◽  
Rectus Muscle ◽  
Strabismus Surgery ◽  
Sinus Surgery ◽  
Medial Rectus ◽  
Inferior Rectus ◽  
Retrospective Case

Background: Extraocular muscle (EOM) injury is a rare but serious complication of endoscopic sinus surgery (ESS). The aim of this study is to describe the clinical characteristics and course of EOM injury occurring during ESS. Design: Retrospective case series. Methods: Medical records and CT images of patients who suffered from EOM injury after ESS between 2006 and 2012 were retrospectively reviewed. Patient demographics, endoscopic anatomy, type of surgery (primary or revision), predisposing risk factors, site and extent of injury on CT imaging, and associated complications were evaluated. In addition, data regarding ophthalmologic management and clinical outcomes were collected. Results: Ten patients with EOM injuries after ESS were included in this study. One patient was undergoing revision ESS. All patients sustained medial rectus muscle injury and one patient suffered concurrent ipsilateral inferior rectus muscle injury. A microdebrider was used in nine cases. Right-sided injury (90% of patients) was more prevalent than left-sided injury, and 70% of injured medial rectus muscles were completely transected. After subsequent strabismus surgery, 8/9 patients regained binocular single vision in primary gaze despite residual diplopia in some gaze positions. Conclusion: Although proper ophthalmologic surgery after EOM injury may improve deviation in the primary gaze position, none of the patients regained normal EOM movement. Therefore, prevention of this complication through adequate surgical technique and precautions is important.

Medial Rectus Muscle Injuries Associated With Functional Endoscopic Sinus Surgery

2003 ◽  
Vol 19 (1) ◽  
pp. 25-37 ◽  
Author(s):  
Christine M. Huang ◽  
Dale R. Meyer ◽  
James R. Patrinely ◽  
Charles N. S. Soparkar ◽  
Roger A. Dailey ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Rectus Muscle ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Medial Rectus ◽  
Muscle Injuries

scholarly journals Medial Rectus Muscle Injuries after Functional Endoscopic Sinus Surgery

2015 ◽  
Vol 45 (4) ◽  
pp. 175-178 ◽  
Author(s):  
Bengi Demirayak ◽  
Özgül Altıntaş ◽  
Hakan Ağır ◽  
Şahin Alagöz
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Rectus Muscle ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Medial Rectus ◽  
Muscle Injuries

scholarly journals Isolated Inferior Rectus Muscle Entrapment following Endoscopic Sinus Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Scott Shapiro ◽  
Jamie L. Schaefer ◽  
Sumeet Gupta ◽  
John Nguyen ◽  
Brian Kellermeyer
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Rectus Muscle ◽  
Sinus Surgery ◽  
Orbital Floor ◽  
Long Term Outcomes ◽  
Inferior Rectus ◽  
Band Formation ◽  
Orbital Complications ◽  
Inferior Rectus Muscle

Orbital complications are known risks of endoscopic sinus surgery (ESS). The lamina papyracea and medial rectus muscle are the most commonly injured structures during ESS. Inferior rectus injury is more rare, with only one reported case of isolated inferior rectus injury in the literature. Guidelines for managing ESS-induced inferior rectus injury do not exist, and delayed intervention and management of adjacent sinuses may affect long-term outcomes such as persistent diplopia and disfigurement. In this report, we present a case of a 67-year-old man with diplopia due to isolated left inferior rectus muscle entrapment and injury from violation of the orbital floor during previous ESS. We postulate that an incomplete maxillary antrostomy contributed to scar band formation and entrapment of the inferior rectus muscle after the orbital floor was violated, and advocate early intervention with a wide, complete maxillary antrostomy if the orbital floor is injured during ESS.

Pharmacological pupil dilatation after sinus surgery

2021 ◽  
Vol 14 (1) ◽  
pp. e236666
Author(s):  
Bassem Mettias ◽  
Tahir Islam ◽  
Theodoros Valsamakis
Keyword(s):  
Case Report ◽  
Endoscopic Sinus Surgery ◽  
Rare Case ◽  
Sinus Surgery ◽  
Lacrimal Duct ◽  
Postoperative Assessment ◽  
Rare Case Report ◽  
High Concern ◽  
Flow Through ◽  
Orbital Complications

Orbital complications after endoscopic sinus surgery are serious problems. Inadvertent contamination of the eye by pharmacological solution can lead to early postoperative anxiety to patients and high concern to surgeons. This is a rare case report of retrograde epinephrine flow through lacrimal duct in sinus surgery with learning tips during postoperative assessment for reassurance in temporary pharmacological effect rather than serious complication.

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