Novel Retinal Complications After Endoscopic Sinus Surgery

Abstract

Macular edema, nonperfusion and ischemia, choroidal nonperfusion (Amalric sign), and atrophy can be iatrogenic sequelae of endoscopic ethmoid sinus surgery.

Aetiology, clinical features and surgical outcomes of isolated medial rectus palsy

“…This indicated that patients with congenital MRP often required strabismus surgery to correct their exotropia as performed by an ophthalmologist, whereas patients with MRP resulting from midbrain infarction are usually managed with drug therapy as administered by neurologists. Endoscopic sinus surgery and trauma (81.25%) were the most common causes of the lesions in our study, consistent with that of previously described 5‐14 . Extraocular muscle injury, especially of the medial rectus, is a rare complication of endoscopic sinus surgery.…”

“…The extremely rare incidence of isolated MRP has severely limited the availability of information on the aetiology, clinical findings, imaging features and therapeutic outcomes of this condition. Based on previous studies involving 59 cases, the most common causes for MRP included complications after endoscopic sinus surgery as observed in 38 (64.40%) patients, followed by trauma in 11 (18.64%), midbrain infarction in eight (13.56%), complications after strabismus surgery in one (1.70%) and medial rectus muscle disinsertion by scleral buckle in one (1.70%) patient 5‐14 . To our knowledge, it is the first time to review isolated MRP, not as a single case presentation.…”

“…Based on previous studies involving 59 cases, the most common causes for MRP included complications after endoscopic sinus surgery as observed in 38 (64.40%) patients, followed by trauma in 11 (18.64%), midbrain infarction in eight (13.56%), complications after strabismus surgery in one (1.70%) and medial rectus muscle disinsertion by scleral buckle in one (1.70%) patient. [5][6][7][8][9][10][11][12][13][14] To our knowledge, it is the first time to review isolated MRP, not as a single case presentation. In our cases, 15.62% had congenital MRP, and there was no existence of mid brain infarction when no neurological symptoms were observed in these cases.…”

“…[1][2][3][4] Isolated medial rectus palsy (MRP) is extremely rare in clinical practice, with only 59 cases being reported in the English literature, often involving single case presentations. [5][6][7][8][9][10][11][12][13][14] Possible aetiologies may include damage of the medial rectus nucleus or terminal branches of the oculomotor nerve serving only the medial rectus, or direct medial rectus muscle injury, such as orbital trauma or surgical complications of endoscopic sinus surgery. Interestingly, the diagnosis and management of MRP by neurologists may differ from that of ophthalmologists.…”

“…In extraocular muscle palsy, CN VI represents the most common type of paralytic strabismus, accounting for 33% to 63% of cases, followed by CN III palsy (22%‐41.2%) and CN IV palsy (11%‐36%) 1‐4 . Isolated medial rectus palsy (MRP) is extremely rare in clinical practice, with only 59 cases being reported in the English literature, often involving single case presentations 5‐14 . Possible aetiologies may include damage of the medial rectus nucleus or terminal branches of the oculomotor nerve serving only the medial rectus, or direct medial rectus muscle injury, such as orbital trauma or surgical complications of endoscopic sinus surgery.…”