Elevation Deficit Caused by Accessory Extraocular Muscle

Valmaggia, Christophe; Zaunbauer, Wolfgang; Gottlob, Irène

doi:10.1016/s0002-9394(14)70445-3

Cited by 26 publications

(7 citation statements)

References 2 publications

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“…To our knowledge there is only one other report of a similar case, wherein MRI revealed such an accessory muscle (Valmaggia et al,1996); this previous report and the current report emphasize that MRI is an excellent imaging method for visualizing anatomical structures in the orbital region. Surgical resection of the accessory muscle may be considered; however, exact imaging of the anatomy of nerves, vessels, fascias, and muscle tissue is particularly important for planning such surgical treatment and also for detecting pathological processes.…”

Section: Discussionsupporting

confidence: 66%

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Accessory eye muscle in a young boy with external ophthalmoplegia

et al. 2011

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A seven-year-old boy presented to the neuropediatric clinic with right-sided ptosis, external ophthalmoplegia, and mental retardation. Orbital magnetic resonance imaging (MRI) revealed anomalous soft tissue within the intraconal region, which was interpreted as an atavistic retractor bulbi muscle. In patients with external ophthalmoplegia and ptosis, anatomic variations observed in MRI should be given due consideration. In fact, knowledge about rare anatomical anomalies may contribute to a more accurate diagnosis of such ocular symptoms.

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Section: Discussionsupporting

confidence: 66%

“…These reports mostly describe the clinical symptoms of the patients. Valmaggia et al (1996) reported the case of a six‐year‐old boy with strabismus and elevation deficit of the left eye. Park and Oh (2003) found left exotropia and ptosis in an 18‐year‐old male patient with congenital third nerve palsy.…”

Section: Discussionmentioning

confidence: 99%

Accessory eye muscle in a young boy with external ophthalmoplegia

et al. 2011

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“…However, intraoperative observation of sustained restriction to supraduction after IR release supports the notion that the anomalous band was indeed a substantial contributor to the patient's strabismus. Other prior reports have similarly suggested that these anomalous bands may be pathologic in some instances and have implicated them as causing restrictive strabismus, globe retraction, and eyelid retraction 6,8,10. Because these bands are often located deep in the orbit, they are difficult to access using traditional strabismic surgical approaches.…”

Section: Discussionmentioning

confidence: 98%

“…Numerical aberrations of the EOMs have been reported, consisting of both absences of rectus and oblique EOMs1,2 as well as supernumerary bands resembling EOMs. Sparse case reports exist describing these supernumerary EOMs, most of which have been discovered postmortem or intraoperatively 3–10. Sacks published one of the first reports describing anomalous EOM bands discovered by cadaveric dissection 4…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Imaging of Tissues Compatible with Supernumerary Extraocular Muscles

Khitri

Demer

2010

American Journal of Ophthalmology

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PURPOSE To determine by magnetic resonance imaging (MRI) the prevalence and anatomy of anomalous EOM bands. DESIGN Prospective, observational case series. METHODS High resolution, multi-positional, surface coil orbital MRI was performed using T1 or T2 fast spin echo weighting with target fixation control under a prospective protocol in normal adult subjects and a diverse group of strabismic patients between 1996 and 2009. Images demonstrating anomalous EOM bands were analyzed digitally to evaluate their sizes and paths, correlating findings with complete ophthalmic and motility examinations. RESULTS Among 118 orthotropic and 453 strabismic subjects, one (0.8%) orthotropic and 11 (2.4%) strabismic subjects exhibited unilateral or bilateral orbital bands having MRI signal characteristics identical to EOM. Most bands occurred without other EOM dysplasia and coursed in the retrobulbar space between rectus EOMs such as medial (MR) to lateral rectus (LR), or superior (SR) to inferior rectus (IR), or from one EOM to the globe. In two cases, horizontal bands from MR to LR immediately posterior to the globe apparently limited supraduction by collision with the optic nerve. All bands were too deep to be approached via conventional strabismus surgical approaches. CONCLUSIONS About 2% of humans exhibit on MRI deep orbital bands consistent with supernumerary EOMs. While band anatomy is non-oculorotary, some bands may cause restrictive strabismus.

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“…The third type of anomalous orbital structure is a separate muscle that originates in the posterior orbit and inserts in an abnormal location. Types of these structures include single discrete structures that insert on the globe in abnormal locations, 22 23 24 25 26 or structures that branch and insert on multiple locations on the normal extraocular muscles. 17 27 The first of these, single discrete structures, has been more commonly reported.…”

Section: Anomalous Orbital Structuresmentioning

confidence: 99%

Orbital causes of incomitant strabismus

Lueder¹

2015

Middle East Afr J Ophthalmol

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Strabismus may result from abnormal innervation, structure, or function of the extraocular muscles. Abnormalities of the orbital bones or masses within the orbit may also cause strabismus due to indirect effects on the extraocular muscles. This paper reviews some disorders of the orbit that are associated with strabismus, including craniofacial malformations, orbital masses, trauma, and anomalous orbital structures.

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Elevation Deficit Caused by Accessory Extraocular Muscle

Cited by 26 publications

References 2 publications

Accessory eye muscle in a young boy with external ophthalmoplegia

Accessory eye muscle in a young boy with external ophthalmoplegia

Magnetic Resonance Imaging of Tissues Compatible with Supernumerary Extraocular Muscles

Orbital causes of incomitant strabismus

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