BACKGROUND: Although the use of endoscopes and image guidance provide some safeguards, motility complications from orbital injury during endoscopic sinus surgery still pose a significant concern and can provide a therapeutic challenge. METHODS: We present the case of a 40-year-old woman with strabismus secondary to an iatrogenic injury to the medial rectus muscle during endoscopic sinus surgery. RESULTS: Permanent resolution of diplopia was achieved with botulinum toxin A injection into the lateral rectus muscle without the need for surgical intervention. CONCLUSION: Botulinum toxin A should be considered as a first-line early therapeutic option for cases of iatrogenically induced strabismus after endoscopic sinus surgery when complete transection or entrapment is not present.
BACKGROUND: Although the use of endoscopes and image guidance provide some safeguards, motility complications from orbital injury during endoscopic sinus surgery still pose a significant concern and can provide a therapeutic challenge. METHODS: We present the case of a 40-year-old woman with strabismus secondary to an iatrogenic injury to the medial rectus muscle during endoscopic sinus surgery. RESULTS: Permanent resolution of diplopia was achieved with botulinum toxin A injection into the lateral rectus muscle without the need for surgical intervention. CONCLUSION: Botulinum toxin A should be considered as a first-line early therapeutic option for cases of iatrogenically induced strabismus after endoscopic sinus surgery when complete transection or entrapment is not present.
Authors: Julio González-Martín-Moro; Julio José González-López; Marco Sales-Sanz; Andrea Sales-Sanz; Javier González-Martín-Moro; Fernando Gómez-Sanz; Mar González-Manrique; Belén Pilo-de-la-Fuente; Roberto García-Leal Journal: Int Ophthalmol Date: 2014-03-07 Impact factor: 2.031