Tooley Andrea A, Levine Benjamin, Godfrey Kyle J, Lisman Richard D, Tran Ann Q, Sherman John E
Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA.
Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA.
Craniomaxillofac Trauma Reconstr. 2020 Sep;13(3):211-214. doi: 10.1177/1943387520928652. Epub 2020 May 21.
Extraocular muscle (EOM) entrapment with resulting reduction in motility and diplopia is a known complication of orbital fractures. Less commonly, transection of the EOMs due to trauma, iatrogenic injury, or intentional myotomy may lead to persistent diplopia. The inferior oblique (IO) is often encountered during orbital surgery along the medial wall and floor, and may be disinserted to aid in visualization. The authors present a case of IO entrapment which occurred during zygomaticomaxillary fracture reduction. Intraoperatively, an IO transection was performed and the muscle was reattached within the orbit. Postoperatively, the patient did not develop diplopia or motility disruption. This technique may provide a useful solution to an unusual problem during orbital fracture repair.
眼外肌（EOM）嵌顿导致眼球运动减少和复视是眼眶骨折的一种已知并发症。较少见的是，由于外伤、医源性损伤或故意进行肌切断术导致眼外肌横断，可能会导致持续性复视。在内侧壁和眶底进行眼眶手术时经常会遇到下斜肌（IO），可能会将其断离以利于视野暴露。作者报告了1例在颧上颌骨折复位过程中发生的下斜肌嵌顿病例。术中进行了下斜肌横断，并将肌肉重新附着于眼眶内。术后，患者未出现复视或眼球运动障碍。该技术可能为眼眶骨折修复过程中一个不常见的问题提供有用的解决方案。
