Bleier Benjamin S, Schlosser Rodney J
Division of Rhinology, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425, USA.
Otolaryngol Clin North Am. 2010 Aug;43(4):801-7. doi: 10.1016/j.otc.2010.04.007. Epub 2010 May 20.
Medial rectus injury is an uncommon but often devastating complication of functional endoscopic sinus surgery. Prevention of these types of injuries is predicated on a thorough preoperative assessment of the position and integrity of the medial orbital wall coupled with excellent surgical technique. The use of powered instrumentation has led to more severe injuries and thus should be used with caution near critical structures such as the lamina papyracea. Early recognition and management of medial rectus and associated orbital injuries is critical to improve outcomes and prevent associated complications. Despite optimal surgical and medical interventions, the prognosis is relatively poor and patients should be counseled that the primary goal of these interventions is to reestablish a binocular single visual field.
内直肌损伤是功能性鼻内镜鼻窦手术中一种少见但往往极具破坏性的并发症。预防此类损伤的前提是在术前对眶内侧壁的位置和完整性进行全面评估，并具备精湛的手术技巧。电动设备的使用导致了更严重的损伤，因此在诸如纸样板等关键结构附近使用时应谨慎。对内直肌及相关眼眶损伤的早期识别和处理对于改善预后及预防相关并发症至关重要。尽管采取了最佳的手术和药物干预措施，预后相对较差，应告知患者这些干预措施的主要目标是重建双眼单视野。
