title: [Management of large exotropia with medial rectus muscle transection following endoscopic sinus surgery].
abstract: OBJECTIVE
  To evaluate and compare the effect of surgeries in large exotropic patients who underwent a medial rectus muscle (MR) transection after endoscopic sinus surgery (ESS).
  
  
  METHODS
  In 5 patients with exotropia (XT) and a lack of adduction after ESS, orbital CT revealed a complete transection of the midportion of the MR. 3 patients was treated within 3 months after injury. Foster procedure in 2 patients, augmented Hümmelsheim procedure in 1 other patients. Two patients were treated over 6 months after ESS with lateral rectus contraction. Surgery was divided into two stages. The adduction deficits were divided into -1 through to -8. The patients were followed up for more than than 6 months.
  
  
  RESULTS
  Postoperatively, 5 patients showed orthophoria or small exophoria within -5°among which 4 had no diplopia in the primary position, another one avoid diplopia by prism lens. The adduction deficits improved to -2 to -5.
  
  
  CONCLUSIONS
  Surgical management (vertical rectus muscle transposition) is effective in correcting a large exotropia secondary to a medial rectus transection after ESS. The best time for surgery is 3 months after injury.
authors.affiliation: Tianjin Eye Hospital, Tianjin 300020, China. yangshiqiang@hotmail.com
authors.forename: Shi-qiang
authors.initials: SQ
authors.lastname: Yang
authors.forename: Xin
authors.initials: X
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000009:adverse effects; D005099:Exotropia / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000293:injuries*; D010256:Paranasal Sinuses / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery*