Medial rectus muscle injuries associated with functional endoscopic sinus surgery: characterization and management.
OBJECTIVE
To characterize and evaluate treatment options for medial rectus muscle (MR) injury associated with functional endoscopic sinus surgery (FESS).


METHODS
Retrospective interventional case series.


METHODS
A total of 30 cases were gathered from 10 centers.


METHODS
Cases of orbital MR injury associated with FESS surgery were solicited from members of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) through an e-mail discussion group.


METHODS
Variables assessed included patient demographics, computerized tomography and operative findings, extent of MR injury and entrapment, secondary orbital/ocular injuries, initial and final ocular alignment and ductions, and interventions.


RESULTS
A spectrum of MR injury ranging from simple contusion to complete MR transection, with and without entrapment, was observed. Four general patterns of presentation and corresponding injury were categorized.


CONCLUSIONS
Medial rectus muscle injury as a complication of FESS can vary markedly. Proper characterization and treatment are important, particularly with reference to the degree of direct MR injury (muscle tissue loss) and entrapment. Patients with severe MR disruption can benefit from intervention but continue to show persistent limitation of ocular motility and functional impairment. Prevention and early recognition and treatment of these injuries are emphasized.
Huang
Christine M
CM
Albany Medical College, Department of Ophthalmology, Albany, New York 12208, U.S.A.
Meyer
Dale R
DR
Patrinely
James R
JR
Soparkar
Charles N S
CN
Dailey
Roger A
RA
Maus
Marlon
M
Rubin
Peter A D
PA
Yeatts
R Patrick
RP
Bersani
Thomas A
TA
Karesh
James W
JW
Harrison
Andrew R
AR
Shovlin
Joseph P
JP
D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000209:etiology* / Q000628:therapy; D009801:Oculomotor Muscles / Q000293:injuries*; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects*; D010254:Paranasal Sinus Diseases / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed