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颞肌筋膜用于治疗内镜鼻窦手术后继发的内直肌损伤:一例报告

Temporalis Fascia for the Management of Medial Rectus Damage Secondary to Endoscopic Sinus Surgery: A Case Report.

作者信息

Bagheri Abbas, Veisi Amirreza, Tavakoli Mehdi

机构信息

Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Curr Ophthalmol. 2021 Oct 22;33(3):354-357. doi: 10.4103/joco.joco_108_20. eCollection 2021 Jul-Sep.

Abstract

PURPOSE

To report a challenging case of medial rectus (MR) damage secondary to endoscopic sinus surgery (ESS).

METHODS

A 37-year-old woman presented with diplopia, exotropia, and adduction deficit of the right eye due to the right MR injury secondary to the ESS.

RESULTS

As a stepwise approach, she respectively underwent repairing of the damaged MR plus ipsilateral lateral rectus recession, half-tendon vertical rectus transposition to the MR insertion, and eventually nasal globe fixation with temporalis fascia that ultimately provided a single vision in the primary position with orthophoria.

CONCLUSIONS

Re-establishment of an acceptable field of a single binocular vision in the context of iatrogenic MR injury is challenging and often requires multiple step-wise operations. Temporalis fascia is a safe and strong autogenous material, which can be used for globe fixation in this setting.

摘要

目的

报告1例因内镜鼻窦手术(ESS)继发内侧直肌(MR)损伤的具有挑战性的病例。

方法

一名37岁女性因ESS继发右眼MR损伤,出现复视、外斜视和右眼内收障碍。

结果

作为一种逐步治疗方法,她分别接受了受损MR修复加同侧外直肌后徙术、半腱肌垂直直肌转位至MR附着点,最终采用颞肌筋膜进行眼球鼻侧固定,最终在第一眼位获得单视且眼位正位。

结论

在医源性MR损伤的情况下,重建可接受的双眼单视野具有挑战性,通常需要多次逐步手术。颞肌筋膜是一种安全且坚固的自体材料,可用于这种情况下的眼球固定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e4c/8579785/ac5c81b85bf7/JCO-33-354-g001.jpg

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