title: Botulinum toxin A therapy for medial rectus injury during endoscopic sinus surgery.
abstract: 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.
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, San Francisco, California 94143, USA. jhong.md@gmail.com
authors.forename: Jenny E
authors.initials: JE
authors.lastname: Hong
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Goldberg
authors.forename: Kimberly P
authors.initials: KP
authors.lastname: Cockerham
mesh_terms: 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
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A