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Updated: Aug 14, 2026
09:07
Techniques of Endoscopic Ossiculoplasty
Published on: January 26, 2024
Ocular motility complications after endoscopic sinus surgery with powered cutting instruments
M T Bhatti1, C M Giannoni, E Raynor
1Department of Ophthalmology, University of Florida, Gainesville 32610-0284, USA. tbhatti@eye1.eye.ufl.edu
Summary
Powered endoscopic sinus surgery can cause serious eye movement problems. Surgeons must be aware of orbital risks to prevent extraocular muscle injury during these procedures.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
- Surgical Safety
Background:
- Powered endoscopic sinus surgery (PESS) offers advancements in treating sinonasal diseases.
- Ocular motility dysfunction is a rare but significant complication associated with PESS.
Observation:
- Two unique cases of ocular motility dysfunction following PESS are presented.
- Case 1: Restrictive global ophthalmoplegia due to inadvertent medial orbital entry.
- Case 2: Complete loss of adduction from medial rectus muscle transection by a powered instrument.
Findings:
- Orbital wall penetration during PESS can lead to severe ophthalmoplegia.
- Powered instruments may draw orbital tissues into the tip, causing injury even without apparent entry.
- Risk factors include proximity to the medial orbit and the mechanics of powered surgical tools.
Implications:
- Enhanced surgeon awareness of orbital anatomy and PESS risks is crucial.
- Careful surgical technique and instrument handling are necessary to minimize ophthalmic complications.
- Further research into instrument design and surgical protocols may improve patient safety during PESS.
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