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Strabismus following endoscopic intranasal sinus surgery.
1Department of Ophthalmology, University of Alabama, Birmingham.
Summary
Endoscopic sinus surgery can cause orbital wall fractures, leading to exotropia and limited eye muscle function. Surgeons must remain vigilant to prevent these rare but serious ocular complications.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
- Surgical Anatomy
Background:
- Endoscopic intranasal ethmoid sinus surgery offers improved visualization of sinonasal anatomy.
- Minimally invasive techniques aim to reduce surgical morbidity.
- Orbital complications are a known risk, though infrequent.
Observation:
- Two patients presented with exotropia and impaired medial rectus muscle function post-endoscopic sinus surgery.
- Both patients were found to have sustained medial orbital wall fractures.
- Ocular motility was affected due to the orbital trauma.
Findings:
- Surgical intervention (horizontal rectus muscle surgery) was required for one patient to restore ocular alignment.
- The second patient experienced persistent limited horizontal motility due to scarring at the fracture site.
- Medial orbital wall fractures can result from endoscopic sinus procedures, impacting eye muscle function.
Implications:
- Despite enhanced visualization, endoscopic sinus surgery carries a risk of orbital injury.
- Ophthalmologists and otolaryngologists must be aware of potential ocular complications.
- Careful surgical technique and orbital wall awareness are crucial during endoscopic sinus procedures to minimize risk.