Iatrogenic inferior oblique palsy: intentional disinsertion during transcaruncular approach to orbital fracture repair

Tiedemann, Laura M.; Lefebvre, Daniel R.; Wan, Michael J.; Dagi, Linda R.

doi:10.1016/j.jaapos.2014.06.005

Cited by 11 publications

(15 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…13 Another case of IO disinsertion during transcaruncular approach for orbital fracture repair lead to an IO palsy which required surgical correction of the persistent hypotropia and incyclotropia. 14 However, other reports of intentional IO disinsertion followed by muscle reposition within the orbit showed no lasting postoperative motility deficits or diplopia. 1,15 The IO is often regarded as a forgiving muscle and may be less likely to elicit diplopia when injured, compared with other EOMs.…”

Section: Discussionmentioning

confidence: 92%

Inferior Oblique Entrapment After Orbital Fracture With Transection and Repair

Tooley

Levine

Godfrey

et al. 2020

Craniomaxillofacial Trauma & Reconstruction

View full text Add to dashboard Cite

Extraocular muscle (EOM) entrapment with resulting reduction in motility and diplopia is a known complication of orbital fractures. Less commonly, transection of the EOMs due to trauma, iatrogenic injury, or intentional myotomy may lead to persistent diplopia. The inferior oblique (IO) is often encountered during orbital surgery along the medial wall and floor, and may be disinserted to aid in visualization. The authors present a case of IO entrapment which occurred during zygomaticomaxillary fracture reduction. Intraoperatively, an IO transection was performed and the muscle was reattached within the orbit. Postoperatively, the patient did not develop diplopia or motility disruption. This technique may provide a useful solution to an unusual problem during orbital fracture repair.

show abstract

Section: Discussionmentioning

confidence: 92%

Inferior Oblique Entrapment After Orbital Fracture With Transection and Repair

Tooley

Levine

Godfrey

et al. 2020

Craniomaxillofacial Trauma & Reconstruction

View full text Add to dashboard Cite

show abstract

“…Seventeen and 23 patients had right and left orbital wall fractures, respectively. The mean follow-up visit was 9 ± 3.47 months (range, [6][7][8][9][10][11][12][13][14][15][16][17]. Patients showed enophthalmos of -1.46 ± 0.25 (range, -5 to 3) mm compared with the normal side.…”

Section: Resultsmentioning

confidence: 99%

“…that IOM manipulation during the cutting and reattaching procedure in group 2 may cause muscle paresis and inflammation and induce initial limitation of eye movement. 15 To summarize these results about IOM underaction, diplopia, and EOM limitation, both surgical skills were equally remarkable and showed similar postoperative sequelae.…”

mentioning

confidence: 89%

Clinical Results According to Inferior Oblique Manipulation in Patients with Inferomedial Blowout Fracture Involving the Orbital Strut

Park

Choi

2022

OPTH

View full text Add to dashboard Cite

Background: Detachment of the inferior oblique muscle may be necessary under certain circumstances to repair a large inferomedial orbital fracture involving the orbital strut. This study aimed to evaluate the outcomes of patients who underwent surgeries with and without inferior oblique muscle reattachment after its detachment to repair the orbital wall fractures. Methods: Forty patients who underwent repair of combined floor and medial orbital wall fracture involving the orbital strut at a single tertiary institution between January 2014 and December 2020 were reviewed. Groups 1 and 2 comprised 20 patients each, who underwent surgery with inferior oblique muscle detachment without and with reattachment, respectively, and were followed up for at least 6 months postoperatively. Enophthalmos, Goldmann diplopia test, alignment test, ocular motility test, and orbital inferomedial angle ratio were the outcome measures. Results: Statistically significant improvement was observed in ocular motility, diplopia, and enophthalmos postoperatively at the 1and 6-month follow-up (p < 0.01). The mean postoperative inferomedial angle ratio (102.28 ± 10.62%) was improved significantly compared with the preoperative inferomedial angle ratio (115.61 ± 4.38%) (p = 0.004) in all patients. After surgery, inferior oblique muscle underaction was observed in seven and six patients in groups 1 and 2, respectively, which was associated with preoperative extraocular movement limitation and strabismus. Two patients showed diplopia in both groups at the last follow-up; they had inferior oblique muscle underaction but no enophthalmos. Conclusion: Orbital fracture repair with or without inferior oblique muscle reattachment was clinically effective and safe; however, patients with preoperative strabismus and extraocular motility limitation should be informed of the increased risk of postoperative complications.

show abstract

“…Adhesion of extraocular muscles, particularly to porous implants, can be equally problematic at times, 196,197 as can iatrogenic disinsertion of the inferior oblique at its origin, which may be required to place an implant along the nasal wall of the orbit. 198…”

Section: P366mentioning

confidence: 99%

Adult Strabismus Preferred Practice Pattern®

Dagi

Velez²,

Archer

et al. 2020

Ophthalmology

Self Cite

View full text Add to dashboard Cite

The Adult Strabismus PPP was then sent for review to additional internal and external groups and individuals in August 2019. All those returning comments were required to provide disclosure of relevant relationships with industry to have their comments considered. Members of the Pediatric Ophthalmology/Strabismus Preferred Practice Pattern Panel reviewed and discussed these comments and determined revisions to the document. The following organizations and individuals returned comments.

show abstract

Iatrogenic inferior oblique palsy: intentional disinsertion during transcaruncular approach to orbital fracture repair

Cited by 11 publications

References 2 publications

Inferior Oblique Entrapment After Orbital Fracture With Transection and Repair

Inferior Oblique Entrapment After Orbital Fracture With Transection and Repair

Clinical Results According to Inferior Oblique Manipulation in Patients with Inferomedial Blowout Fracture Involving the Orbital Strut

Adult Strabismus Preferred Practice Pattern®

Contact Info

Product

Resources

About