Treatment of subtotal medial rectus myectomy complicating functional endoscopic sinus surgery

Trotter, William L; Kaw, Pamela; Meyer, Dale R.; Simon, John W.

doi:10.1067/mpa.2000.106202

Cited by 27 publications

(24 citation statements)

References 12 publications

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“…Owing to the rare occurrence of extraocular muscle injury following endoscopic sinus surgery, there are few reports on the treatment strategies in these patients. [1][2][3][4] In the present study, we reported the results of surgical correction in patients with medial rectus (MR) injury incurred during endoscopic sinus surgery and further discussed the treatment strategies.…”

Section: Introductionmentioning

confidence: 99%

Extraocular muscle injury during endoscopic sinus surgery: an ophthalmologic perspective

2016

Eye

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Purpose The purpose of this study is to describe the clinical characteristics and treatment results of medial rectus muscle (MR) transection incurred during endoscopic sinus surgery. Methods This retrospective study included 16 patients with MR transection incurred during endoscopic sinus surgery between 1994 and 2015. The operative notes of the surgical procedure, the pattern of strabismus, the type of muscle injury, the type of corrective strabismus surgery, and the surgical outcomes were reviewed. Results Nine patients had partial resection of MR and seven patients had complete transection of MR, resulting from an injury incurred during endoscopic sinus surgery. Three of the nine patients with partial resection injury were initially diagnosed as complete resection and subsequently rediagnosed as partial resection in a review of the images during this study. Five of the nine patients with partial MR resection underwent only simple recession/resection surgery. Patients with complete MR transection underwent muscle transposition or globe fixation surgeries and often multiple operations were required. Conclusions The results of this study showed that the treatment strategies could vary depending on the nature of muscle injury. In cases with complete transection, muscle transposition or globe fixation surgeries are often required, with multiple operations. However, partial muscle resection with only simple recession/resection surgery shows a favorable outcome in many cases. The use of proper imaging techniques, a thorough review of the images with various planes, and close follow-up are important for determining the nature of the muscle injury.

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Section: Introductionmentioning

confidence: 99%

Extraocular muscle injury during endoscopic sinus surgery: an ophthalmologic perspective

2016

Eye

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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: 66%

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: 66%

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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Treatment of subtotal medial rectus myectomy complicating functional endoscopic sinus surgery

Cited by 27 publications

References 12 publications

Extraocular muscle injury during endoscopic sinus surgery: an ophthalmologic perspective

Extraocular muscle injury during endoscopic sinus surgery: an ophthalmologic perspective

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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