title: [Management of motility disorders secondary to iatrogenic orbital fracture during endoscopic sinus surgery].
abstract: OBJECTIVE
  Orbital wall fracture may occur during endoscopic sinus surgery, resulting in oculomotor disorders. We report the management of four cases presenting with this surgical complication.
  
  
  METHODS
  A non-comparative observational retrospective study was carried out on four patients presenting with diplopia after endoscopic ethmoidal sinus surgery. All patients underwent full ophthalmologic and orthoptic examination as well as orbital imaging.
  
  
  RESULTS
  All four patients presented with diplopia secondary to a medial rectus lesion confirmed by orbital imaging. A large horizontal deviation as well as limitation of adduction was present in all cases. Surgical management consisted of conventional recession-resection procedures in three cases and muscle transposition in one patient. A useful field of binocular single vision was restored in two of the four patients.
  
  
  CONCLUSIONS
  Orbital injury may occur during endoscopic sinus surgery and cause diplopia, usually secondary to medial rectus involvement due to the proximity of this muscle to the lamina papyracea of the ethmoid bone. Surgical management is based on orbital imaging, duration of the lesion, evaluation of anterior segment vasculature, results of forced duction testing and intraoperative findings. In most cases, treatment is aimed at the symptoms rather than the cause, and the functional prognosis remains guarded.
authors: Hôpital ophtalmique Jules-Gonin, avenue de France 15, 1004 Lausanne, Suisse.
authors: P-F
authors: PF
authors: Kaeser
authors: G
authors: G
authors: Klainguti
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000209:etiology*; D009917:Orbital Fractures / Q000150:complications* / Q000209:etiology*; D012189:Retrospective Studies