Mt. Bhatti et al., Ocular motility complications after endoscopic sinus surgery with powered cutting instruments, OTO H N SUR, 125(5), 2001, pp. 501-509
OBJECTIVE: The purpose of this study was to describe 2 unique cases of ocul
ar motility dysfunction after powered endoscopic sinus surgery and identify
potential risk factors for extraocular muscle injury.
STUDY DESIGN. Interventional case series.
RESULTS., Patient I developed a restrictive global ophthalmoplegia after in
advertent entry into the medial orbit during powered endoscopic sinus surge
ry. Patient 2 had complete loss of adduction of the left eye as a result of
transection of the medial rectus muscle by a powered cuffing instrument.
CONCLUSIONS: Despite advances in endoscopic sinus surgery technique and ins
trumentation, serious ophthalmic complications may still occur. Inadvertent
entry into the medial orbital wall can result in ocular motility complicat
ions. Furthermore, it is possible that attraction of orbital contents into
the tip of a powered cutting instrument may occur without significant entry
into the orbital cavity.
SIGNIFICANCE: It is important for endoscopic sinus surgeons to be aware of
the intimate anatomical relationship between the orbit and sinuses, as well
as the potential risks of the current instruments used in endoscopic sinus
surgery.