Ela-Dalman N, Velez F G, Rosenbaum A L
MD 100 Stein Plaza, UCLA, Los Angeles, CA 90095, USA.
Br J Ophthalmol. 2006 Jun;90(6):682-5. doi: 10.1136/bjo.2005.088120. Epub 2006 Feb 17.
BACKGROUND/AIMS: Orbital trauma may result in severe restrictive, paralytic, or combined strabismus. Clinical diagnosis may be extremely challenging. Orbital imaging is helpful in determining the exact site of injury, functionality, and integrity of the extraocular muscles. A typical study now includes coronal and axial views of the muscles. This study aimed to emphasise the importance of sagittal imaging of the orbit when evaluating extraocular muscle injury or entrapment.
A retrospective review of two subjects who underwent endoscopic sinus surgery procedures that resulted in trauma to the medial rectus muscle. High resolution orbital imaging studies were performed.
High resolution magnetic resonance imaging (MRI) scans with coronal and axial views suggested a large section of the muscle was not present and was probably destroyed. In both cases there was a displacement of the mid-portion of the medial rectus muscle into an area of bony defect not seen on the axial and coronal views. Sagittal images demonstrated continuity between the anterior and posterior segments of the medial rectus muscle in each case.
Surgical strategies are dependent on accurate interpretation of MRI scans. Muscle displacement may result in axial and coronal orbital imaging misinterpretation. Sagittal views were essential to determine muscle integrity.
背景/目的：眼眶外伤可能导致严重的限制性、麻痹性或混合性斜视。临床诊断可能极具挑战性。眼眶成像有助于确定眼外肌损伤的确切部位、功能及完整性。目前典型的检查包括肌肉的冠状位和轴位图像。本研究旨在强调在评估眼外肌损伤或嵌顿时眼眶矢状位成像的重要性。
回顾性分析两名因内镜鼻窦手术导致内直肌损伤的患者。进行了高分辨率眼眶成像研究。
冠状位和轴位的高分辨率磁共振成像（MRI）扫描显示大片肌肉缺失，可能已被破坏。在这两个病例中，内直肌中部均移位至轴位和冠状位图像上未见的骨缺损区域。矢状位图像显示每个病例内直肌前后段均连续。
手术策略取决于对MRI扫描的准确解读。肌肉移位可能导致眼眶轴位和冠状位成像出现误判。矢状位视图对于确定肌肉完整性至关重要。
