Ocular Motility Disorders Secondary to Sinus Surgery

Penne, R.B.; Flanagan, Joseph C.; Stefanyszyn, Mary A.; Nowinski, Thaddeus S.

doi:10.1097/00002341-199303000-00009

Cited by 34 publications

(26 citation statements)

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“…Although the optic canal in the posterior ethmoid and in the sphenoid sinus is known to be incriminated in major complications of sinus surgery, 4‐6,10,11 our study showed that it is generally a relatively robust structure. The same remark holds true for regions of the ethmoid roof tested in this work.…”

Section: Discussionmentioning

confidence: 54%

Evaluation of the Bone Resistance of the Sphenoid and Ethmoid Sinuses

1997

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Functional endoscopic sinus surgery can be associated with iatrogenic complications. Some anatomical structures have been identified this clinically as specific danger sites. The aim of this study was to confirm and to compare these clinical data with measurements of the bone resistance of the sphenoid and ethmoid walls and to point out regions that have increased bony fragility. Critical dynamometric evaluation of the resistance to breakage of these bony structures was made on 21 anatomic specimens. This study allowed the authors to localization of surgical complications, to demonstrate that other regions renowned for their fragility can be relatively robust, and to point out that robust sites can be dangerously fragile as a result of individual morphological variations. Results from this study provide a supplement to the guidelines for novice surgeons to use in identifying dangerous areas.

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Section: Discussionmentioning

confidence: 54%

Evaluation of the Bone Resistance of the Sphenoid and Ethmoid Sinuses

1997

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“…However, an attempt to recover the stump was indicated in 4 patients and the following results were not promising. Although marked improvement in primary ocular alignment was achieved after a MR posterior stump was reattached to the globe, there was rarely a recovery of the adduction function 12,15,23,25. Four patients in this study also obtained good ocular alignment through VRM transposition without any attempts to recover the MR stump.…”

Section: Discussionmentioning

confidence: 67%

“…When the MR is completely transected, the purpose of reattaching the lacerated ends include correcting the XT, improving the adduction function and reducing the risk of anterior segment ischemia by avoiding additional VRM transposition 15,23. It is seldom possible to examine the MR more posteriorly in the orbit through a conjuncival incision during conventional strabismus surgery 20.…”

Section: Discussionmentioning

confidence: 99%

A Simple New Method for Identifying the Proximal Cut End in Lower Canalicular Laceration

Cho

Hyun

Kang

et al. 2008

Korean J Ophthalmol

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PurposeWe report a simple and effective method of identifying the medial cut end of lower canalicular laceration cases.MethodsTwenty-seven eyes with lower canalicular lacerations as a result of trauma were involved in the study. Surgery was performed within 48 hours after injury for canalicular reconstruction. Upper canalicular probing was utilized to identify the medial cut end of deep canalicular lacerations when difficulties were encountered. Total time from the initiation of the probing procedure to the identification of the medial cut end of the lower canaliculus was measured.ResultsA total of 27 eyes with lower canalicular lacerations were reconstructed. In 20 eyes, the medial lacerated end was located by upper canalicular probing. The mean time from initiation of the probing procedure to identification of the medial cut end of the lacerated canaliculus was 2 minutes.ConclusionsWe conclude that upper canalicular probing in patients with lower canalicular lacerations significantly reduces the time from the initiation of the operation to the identification of the medial cut end of the lower canaliculus.

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Section: Discussionmentioning

confidence: 67%

Vertical Rectus Muscles Transposition in Large Exotropia with Medial Rectus Muscle Transection Following Endoscopic Sinus Surgery

Cho

Rah

Kim

et al. 2008

Korean J Ophthalmol

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PurposeTo evaluate the effect of transposition procedures on the vertical rectus muscle (VRM) in the patients who underwent a medial rectus muscle (MR) transection after endoscopic sinus surgery (ESS).MethodsIn 4 patients with exotropia (XT) and a lack of adduction after ESS, orbital CT or MRI revealed a complete transection of the midportion of the MR. Full-tendon VRM transposition was performed within 3 months after injury (early surgery) in 2 patients with 40Δ XT. Two patients with 70Δ and 85Δ XT underwent an X-type augmented Hümmelsheim procedure, which involved pulling each half-tendon and crossing it through the undersurface of the severed MR to the other end of the MR insertion, concurrently with an ipsilateral lateral rectus (LR) recession 11 months and 36 months after ESS, respectively. The adduction deficits were divided into -1 through to -8. The patients were followed up for more than than 1.5 years.ResultsPostoperatively, 3 patients showed orthophoria and no diplopia in the primary position. The adduction deficits improved to -3.5 or -4. One patient who underwent an X-type augmented Hümmelsheim procedure showed a residual XT of 25Δ.ConclusionsVRM transposition is effective in correcting a large XT secondary to a MR transection after ESS. When a longstanding large-angle XT with severe contracture of the ipsilateral LR and massive scarring of the adjacent tissues is present, the X-type augmented Hümmelsheim procedure coupled with an ipsilateral LR recession had an augmenting effect.

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Ocular Motility Disorders Secondary to Sinus Surgery

Cited by 34 publications

References 0 publications

Evaluation of the Bone Resistance of the Sphenoid and Ethmoid Sinuses

Evaluation of the Bone Resistance of the Sphenoid and Ethmoid Sinuses

A Simple New Method for Identifying the Proximal Cut End in Lower Canalicular Laceration

Vertical Rectus Muscles Transposition in Large Exotropia with Medial Rectus Muscle Transection Following Endoscopic Sinus Surgery

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