Botulinum toxin A therapy for medial rectus injury during endoscopic sinus surgery.
BACKGROUND
Although the use of endoscopes and image guidance provide some safeguards, motility complications from orbital injury during endoscopic sinus surgery still pose a significant concern and can provide a therapeutic challenge.


METHODS
We present the case of a 40-year-old woman with strabismus secondary to an iatrogenic injury to the medial rectus muscle during endoscopic sinus surgery.


RESULTS
Permanent resolution of diplopia was achieved with botulinum toxin A injection into the lateral rectus muscle without the need for surgical intervention.


CONCLUSIONS
Botulinum toxin A should be considered as a first-line early therapeutic option for cases of iatrogenically induced strabismus after endoscopic sinus surgery when complete transection or entrapment is not present.
Hong
Jenny E
JE
Department of Ophthalmology, University of California, San Francisco, San Francisco, California 94143, USA. jhong.md@gmail.com
Goldberg
Andrew N
AN
Cockerham
Kimberly P
KP
D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004172:Diplopia / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D004724:Endoscopy / Q000009:adverse effects*; D005133:Eye Movements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D008279:Magnetic Resonance Imaging; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D009801:Oculomotor Muscles / Q000293:injuries*; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D012852:Sinusitis / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A