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

Cho, Yoonae A.; Rah, Sang Hoon; Kim, Myung Mi; Lee, Joo Yeon

doi:10.3341/kjo.2008.22.2.104

Cited by 11 publications

(5 citation statements)

References 23 publications

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“…Repair of the medial orbital wall usually cannot prevent secondary scar formation. [ 11 , 17 , 18 ] In our experience, recovery of the medial rectus was abandoned in 2 cases where severe entrapment and/or adhesion were present and strabismus surgery was employed in these cases. Two of the 27 cases in our study had their medial wall defect repaired through a transconjunctival orbitotomy.…”

Section: Discussionmentioning

confidence: 97%

“…The range of adduction deficits were recorded at the version test using the following scales: 0 indicated full adduction – free arrival of medial limbus at the medial canthal area, −4 indicates that the medial limbus could not past midline, and −1, −2, and −3 indicated that the eye could rotate nasally from the midline to 75%, 50%, and 25% of full adduction, respectively. [ 11 ] A forced duction test and a forced generation test using toothed forceps were performed to determine restriction or paresis of the affected muscle. If the globe could not be passively rotated further than the patient's effort, restriction was diagnosed; if passive rotation was possible, paresis was diagnosed.…”

Section: Methodsmentioning

confidence: 99%

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Long-term therapeutic outcome of ophthalmic complications following endoscopic sinus surgery

He-ping

Shen²,

Chen³

et al. 2016

Medicine

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Ophthalmic complications associated with endoscopic sinus surgery (ESS) are quite rare. There is a paucity of reliable data and limited experience on the clinical findings and treatments of these injuries. Our study here is to characterize the types of orbital injury following ESS, in particular extraocular muscle injury, and to evaluate the long-term therapeutic outcomes as compiled from a relatively large sample of Chinese patients.A series of 27 patients (21 males and 6 females; mean age = 42.6 years, ranges: 10–60 years) were retrospectively reviewed. The mean duration of orbital complication was 6.6 months (ranges: 1 day to 24 months). The right eye was affected in 19 patients and the left in 8 patients. All patients had various extraocular muscle dysfunction, including contusion, oculomotor nerve damage, muscle entrapment, muscle transection, and muscle destruction. All patients subjected to strabismus surgery showed an obvious reduction in deviation. Three patients achieved orthophoria without any surgery during the period of observation. All patients displayed mild to complicated orbital hemorrhage that often disappeared within 2 weeks. Optic nerve injury occurred in 29.6% of patients and vision damage in these patients was often irreversible.All patients with ophthalmic complications after ESS had strabismus and extraocular muscle dysfunction. Timing and type of strabismus surgery performed depended on the severity and number of muscles involved as well as the type of injury. This surgery is less effective in cases of restriction factor adhesion and/or entrapment as compared to that of patients with other types of strabismus. Orbital hemorrhages were usually resolved spontaneously, but optic nerve injury was mostly irreversible.

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Section: Discussionmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

Long-term therapeutic outcome of ophthalmic complications following endoscopic sinus surgery

He-ping

Shen²,

Chen³

et al. 2016

Medicine

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“…All patients underwent an augmented Hummelsheim procedure (3) or X-type transposition (9) with modifications as documented in Supplemental Digital Content 1 (see Supplemental Table 1 , http://links.lww.com/WNO/A516). Supplemental Digital Content 2 (see supplemental methods, http://links.lww.com/WNO/A515 for more details).…”

Section: Methodsmentioning

confidence: 99%

“…Posterior muscle union combined with posterior scleral fixation sutures has been shown to augment the transposition effect by increasing the tonic contractile forces generated by the muscles and by redirecting the vector forces of the muscle so that they are more parallel to the action of the paralyzed muscle (7). To further increase the tonic forces of the transposed muscle segments, Brooks et al proposed concurrent resection of the transposed segment (8), whereas Cho et al found success with an X-type augmentation in which the transposed muscles are crossed under the paralytic muscle (9).…”

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confidence: 99%

Surgical Outcomes of Transposition Surgery for the Correction of Large-Angle Strabismus

Gokoffski¹,

Lifton²,

Xu³

et al. 2021

Journal of Neuro-Ophthalmology

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Background: Many potential surgical options exist to address large-angle deviations and head turns that result from various forms of paralytic strabismus. Muscle transposition surgeries serve as suitable alternatives to simple resection-recessions. Here, we report outcomes of augmented Hummelsheim and X-type transpositions for the correction of large-angle strabismus and provide insights for surgical planning. Methods: We performed a retrospective chart review of 40 consecutive patients with strabismus who were treated with an augmented Hummelsheim or X-type transposition surgery at a single academic medical center. Etiologies included cranial nerve palsies (n = 26), monocular elevation palsy (n = 3), Duane syndrome (n = 1), traumatic extraocular muscle damage (n = 8), and chronic progressive external ophthalmoplegia (n = 2). All patients were followed for a minimum of 2 months postsurgery. Logistic regression analyses were performed to assess for predictors of surgical outcome. Results: Forty consecutive patients were enrolled in our series. The median preoperative deviation was 46.5D (interquartile range [IQR] 35-70). The median postoperative deviation 2 months after surgery was 0.5D (IQR 0-9.5), which represented a significant improvement (P , 0.001). Thirtythree patients (82.5%) experienced an improvement in range and/or centration of binocular single vision (BSV). More patients who underwent an augmented Hummelsheim procedure and had a small overcorrection at postoperative day 3 had a favorable result on postoperative month 2 (79%) com-pared with those that were initially under-corrected (38%). Multiple logistic regressions found larger preoperative deviation (P , 0.005) and esotropia (P , 0.021) to be predictors of a less favorable surgical outcome (C-statistic = 0.83). Subgroup analysis revealed that less, favorable outcome after X-type transposition occurred most frequently in patients undergoing correction of an esodeviation. Conclusion: Augmented Hummelsheim transposition techniques offer effective treatment options for paralytic strabismus with esotropic deviations, whereas X-type transpositions are effective for exotropic deviations and deviations from severe inferior rectus damage. In addition to potentially providing a wider field of BSV, improved centration is often achieved.

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“…Treatments may require neurosurgical intervention as well as strabismus surgery, depending on the visual acuity of the patients, the cause of their ONP, the angle of deviation, and the presence of amblyopia [ 6 ]. Although appropriate surgical procedures can be rewarding for ONP patients [ 7 – 9 ], the long-term outcomes between different surgical options showed no statistically significant difference [ 10 ]. Therefore, further insight into ONP is urgently needed for better evaluation and management of ONP.…”

Section: Introductionmentioning

confidence: 99%

Identification and characterization of differentially expressed circular RNAs in extraocular muscle of oculomotor nerve palsy

Shi,

Fang,

Liang

et al. 2023

BMC Genomics

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Background Oculomotor nerve palsy (ONP) is a neuroparalytic disorder resulting in dysfunction of innervating extraocular muscles (EOMs), of which the pathological characteristics remain underexplored. Methods In this study, medial rectus muscle tissue samples from four ONP patients and four constant exotropia (CXT) patients were collected for RNA sequencing. Differentially expressed circular RNAs (circRNAs) were identified and included in functional enrichment analysis, followed by interaction analysis with microRNAs and mRNAs as well as RNA binding proteins. Furthermore, RT-qPCR was used to validate the expression level of the differentially expressed circRNAs. Results A total of 84 differentially expressed circRNAs were identified from 10,504 predicted circRNAs. Functional enrichment analysis indicated that the differentially expressed circRNAs significantly correlated with skeletal muscle contraction. In addition, interaction analyses showed that up-regulated circRNA_03628 was significantly interacted with RNA binding protein AGO2 and EIF4A3 as well as microRNA hsa-miR-188-5p and hsa-miR-4529-5p. The up-regulation of circRNA_03628 was validated by RT-qPCR, followed by further elaboration of the expression, location and clinical significance of circRNA_03628 in EOMs of ONP. Conclusions Our study may shed light on the role of differentially expressed circRNAs, especially circRNA_03628, in the pathological changes of EOMs in ONP.

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

Cited by 11 publications

References 23 publications

Long-term therapeutic outcome of ophthalmic complications following endoscopic sinus surgery

Long-term therapeutic outcome of ophthalmic complications following endoscopic sinus surgery

Surgical Outcomes of Transposition Surgery for the Correction of Large-Angle Strabismus

Identification and characterization of differentially expressed circular RNAs in extraocular muscle of oculomotor nerve palsy

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