Ocular motility complications after endoscopic sinus surgery with powered cutting instruments.
OBJECTIVE
The purpose of this study was to describe 2 unique cases of ocular motility dysfunction after powered endoscopic sinus surgery and identify potential risk factors for extraocular muscle injury.


METHODS
Interventional case series.


RESULTS
Patient 1 developed a restrictive global ophthalmoplegia after inadvertent entry into the medial orbit during powered endoscopic sinus surgery. Patient 2 had complete loss of adduction of the left eye as a result of transection of the medial rectus muscle by a powered cutting instrument.


CONCLUSIONS
Despite advances in endoscopic sinus surgery technique and instrumentation, serious ophthalmic complications may still occur. Inadvertent entry into the medial orbital wall can result in ocular motility complications. Furthermore, it is possible that attraction of orbital contents into the tip of a powered cutting instrument may occur without significant entry into the orbital cavity.


CONCLUSIONS
It is important for endoscopic sinus surgeons to be aware of the intimate anatomical relationship between the orbit and sinuses, as well as the potential risks of the current instruments used in endoscopic sinus surgery.
Bhatti
M T
MT
Department of Ophthalmology, University of Florida, Gainesville 32610-0284, USA. tbhatti@eye1.eye.ufl.edu
Giannoni
C M
CM
Raynor
E
E
Monshizadeh
R
R
Levine
L M
LM
D002648:Child; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000209:etiology*; D009801:Oculomotor Muscles / Q000293:injuries*; D009886:Ophthalmoplegia / Q000209:etiology; D009915:Orbit / Q000000981:diagnostic imaging; D013506:Otologic Surgical Procedures / Q000009:adverse effects*; D012852:Sinusitis / Q000601:surgery*; D014057:Tomography, X-Ray Computed