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

Thacker, Neepa; Velez, Federico G.; Demer, Joseph L.; Wang, Marilene B.; Rosenbaum, Arthur L.

doi:10.1177/194589240501900414

Cited by 49 publications

(50 citation statements)

References 15 publications

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“…The severity of destruction in this study may be related to the use of the powered devices. 9 We attempted to find muscle stumps in two cases with short residual proximal muscle tissue and sutured with a non-absorbable suture; however, there was a recurrence of exodeviation over time. Recurrence of exodeviation may be due to loosening of the suture or remodeling of the tissues where the suture was anchored.…”

Section: Discussionmentioning

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: Discussionmentioning

confidence: 99%

Extraocular muscle injury during endoscopic sinus surgery: an ophthalmologic perspective

2016

Eye

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“…Thus, over the course of mere seconds, a small unrecognized dural violation can quickly escalate to brain injury, and a periorbital transgression can instantaneously result in extraocular muscle transection (most typically the medial rectus). 34,35 To prevent shaver complications, it is imperative for the surgeon to position the working window of the blade tip within direct endoscopic view during tissue removal rather than plunging the tip blindly into the surgical field. The strength of the wall suction should also be carefully monitored and an appropriate level of suction should be regulated.…”

Section: Intraoperative Phasementioning

confidence: 99%

Avoiding Complications in Endoscopic Sinus Surgery

Humphreys

Hwang

2015

Otolaryngologic Clinics of North America

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“…Gefährdet ist am ehesten das mittlere oder hintere Siebbein -hier liegt kein oder nur sehr wenig Fett zwischen Muskel und knöcherner Orbitawand [ 76 , 104 , 363 , 450 ] . In seltenen Fällen besteht ein besonderes Risiko durch eine kongenitale oder posttraumatische Ausbuchtung der Lamina papyracea mit oder ohne direkte Einlagerung von Anteilen des Muskels [ 107 , 451 ] intraoperativ über den Bulbus-Drucktest nachzuweisen sein [ 454 ] . Muss darüber hinaus intraoperativ der Verdacht auf einen Augenmuskelschaden ausgesprochen werden, dann sollte ein Augenarzt ohne Verzug benachrichtigt und hinzugezogen werden [ 113 , 363 ] .…”

Section: Diplopieunclassified

“…Muss darüber hinaus intraoperativ der Verdacht auf einen Augenmuskelschaden ausgesprochen werden, dann sollte ein Augenarzt ohne Verzug benachrichtigt und hinzugezogen werden [ 113 , 363 ] . Mit wenigen Ausnahmen tritt die Diplopie als Schädigungsfolge postoperativ sofort auf [ 454 ] . Alle relevanten Befunde sollten umgehend einer Bestandsaufnahme durch eine Bildgebung zugeführt werden.…”

Section: Diplopieunclassified

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Fehler und Gefahren: Eingriffe an den Nasennebenhöhlen und der Frontobasis unter Berücksichtigung mediko-legaler Aspekte

Hosemann

2013

Laryngo-Rhino-Otol

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Endoscopic endonasal sinus surgery represents the overall accepted type of surgical treatment for chronic rhinosinusitis. Notwithstanding raised and still evolving quality standards, surgeons performing routine endoscopic interventions are faced with minor complications in 5% and major complications in 0.5-1%.A comprehensive review on all minor and major complications of endoscopic surgery of the paranasal sinuses and also on the anterior skull base is presented listing the actual scientific literature. The pathogenesis, signs and symptoms of each complication are reviewed and therapeutic regimens are discussed in detail relating to actual publication references. Potential medico-legal aspects are explicated and recent algorithms of avoidance are mentioned taking into account options in surgical training and education.

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

Abstract: Extraocular muscle damage complicating endoscopic sinus surgery can produce therapeutically challenging complicated strabismus.

Cited by 49 publications

References 15 publications

Extraocular muscle injury during endoscopic sinus surgery: an ophthalmologic perspective

Extraocular muscle injury during endoscopic sinus surgery: an ophthalmologic perspective

Avoiding Complications in Endoscopic Sinus Surgery

Fehler und Gefahren: Eingriffe an den Nasennebenhöhlen und der Frontobasis unter Berücksichtigung mediko-legaler Aspekte

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