Rosenbaum A L, Astle W F
J Pediatr Ophthalmol Strabismus. 1985 Sep-Oct;22(5):194-202. doi: 10.3928/0191-3913-19850901-08.
Chronic inflammatory sinus disease is a common process, sometimes requiring nasal and paranasal sinus surgery. Extraocular muscle dysfunction is a rare surgical complication of sinus surgery, but has been reported. Previous studies have been concerned with trauma to the medial rectus muscle resulting in severe paralysis or restriction. This study reports five patients with acquired strabismus and symptomatic vertical diplopia secondary to sinus surgery. In all patients, the resultant diplopia was disabling. Four patients had frontal sinus window surgery performed, with incisions placed in the supero-nasal quadrant of the orbit, below the eyebrow (a modified Lynch incision). Three patients acquired a superior oblique paresis and the fourth developed a Brown's syndrome. The location of the skin incision was critical to injury in the trochlear area. The fifth patient underwent a nasal polypectomy and antrostomy with secondary orbital hemorrhage and proptosis. A mild inferior rectus paresis was the result.
慢性炎症性鼻窦疾病是一种常见病症，有时需要进行鼻腔和鼻窦手术。眼外肌功能障碍是鼻窦手术罕见的手术并发症，但已有相关报道。既往研究关注的是内直肌损伤导致严重麻痹或受限。本研究报告了5例因鼻窦手术继发后天性斜视和有症状性垂直复视的患者。所有患者的复视均导致功能障碍。4例患者接受了额窦开窗手术，切口位于眼眶鼻上象限、眉毛下方（改良林奇切口）。3例患者出现上斜肌麻痹，第4例发展为布朗综合征。皮肤切口位置对于滑车区域的损伤至关重要。第5例患者接受了鼻息肉切除术和上颌窦造口术，继发眼眶出血和眼球突出，结果导致轻度下直肌麻痹。
