Case Report

A Complication Of Endoscopic Sinus Surgery: Extraocular Muscle Damage - Case Report

  • Ayça Sari
  • Ufuk Adigüzel
  • Erdem Dinç
  • Murat Ünal
  • Emin Güçlü

Turk J Ophthalmol 2009;39(1):76-80

Purpose: To review the ocular complications of endoscopic sinus surgery (ESS) and present a patient with a medial rectus muscle damage following ESS. Methods: A 12 years old male patient underwent ESS for chronic sinusitis and complained of diplopia. He had 10 prism diopters of exotropia and a limited adduction (-4) of the right eye. Orbital magnetic resonance imaging demonstrated a defect in the medial rectus muscle integrity. Results: Surgical exploration revealed that the integrity of medial rectus muscle was disrupted 8 mm beyond the insertion site. Most of the fibers were found and sutured to the proximal end. Three months after the operation the patient was orthotropic, had no diplopia and had a complete adduction (+4). Discussion: The intimate relation between the paranasal sinuses and the orbit creates a complication risk for the orbital contents during an endoscopic sinus surgery. Particularly in ethmoidal sinus surgeries, an injury to lamina papricea may complicate with an extraocular muscle damage. The muscle damage can vary from simple contusion to complete transection. The timing and type of surgical approach to the patient depends on the severity, location and the number of muscles involved.

Keywords: endoscopic sinüs surgery, complication, extraocular muscle damage