[Treatment of a complication after surgical removal of an aneurysmal cyst of the ethmoid].
BACKGROUND
An aneurysmal cyst (AC) is a rare benign bony tumor with a possible aggressive extension. We present a complication following the surgical ablation of an ethmoidal AC. CLINICAL HISTORY AND FINDINGS: A 40-year-old man with a left ethmoidal AC extending to the orbital roof underwent 2 surgeries. After the second one involving a neuro-surgical approach, a bilateral palsy of the superior oblique muscles (SO) appeared. The diplopia did not improve following a bilateral asymmetrical recession of the inferior recti muscles done elsewhere. There was an excyclotorsion up to 20 degrees in down gaze and a vertical deviation of 10 degrees in primary position.


RESULTS
We performed a bilateral tucking of the anterior SO fibres with, on the left, an advancement of the inferior rectus and a resection of the medial rectus muscles. Two weeks after surgery the absence of cyclotorsional deviation allowed a binocular vision.


CONCLUSIONS
The double vision due to the excyclotorsion, which was the main complaint, could be alleviated by an anterior strengthening of the SO. A precise measurement of the cyclotorsion is required for the surgical procedure.
Durig
J S
JS
Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland. jsdurig@bluemail.ch
Klainguti
G
G
D000328:Adult; D017824:Bone Cysts, Aneurysmal / Q000175:diagnosis / Q000601:surgery*; D003937:Diagnosis, Differential; D004172:Diplopia / Q000175:diagnosis / Q000601:surgery*; D005004:Ethmoid Bone / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery*; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D020432:Trochlear Nerve Diseases / Q000175:diagnosis / Q000601:surgery*; D015348:Vision, Binocular / Q000502:physiology