Penne R B, Flanagan J C, Stefanyszyn M A, Nowinski T
Oculoplastic Department, Wills Eye Hospital, Philadelphia, PA 19107.
Ophthalmic Plast Reconstr Surg. 1993;9(1):53-61. doi: 10.1097/00002341-199303000-00009.
Sinus surgery has multiple potential ocular complications including visual loss, diplopia, infection, hemorrhage, and epiphora. We report six patients with ocular motility problems secondary to sinus surgery, review the literature on ocular motility disorders secondary to sinus surgery, and propose an approach for management of those ocular motility problems following sinus surgery. Intranasal sinus surgery was found to be the most common procedure resulting in injury to an extraocular muscle and the ethmoid sinus the most common structure being operated on when injury occurred. The medial rectus was the muscle most commonly injured and it had the poorest prognosis for recovery of functional vision free of diplopia. Optimal timing for repair depends on the structure injured, but early recognition and management appear to be a key to the best outcome for these injuries.
鼻窦手术有多种潜在的眼部并发症,包括视力丧失、复视、感染、出血和溢泪。我们报告6例鼻窦手术后继发眼球运动问题的患者,回顾鼻窦手术后继发眼球运动障碍的文献,并提出一种鼻窦手术后这些眼球运动问题的处理方法。发现鼻内鼻窦手术是导致眼外肌损伤最常见的手术,筛窦是损伤发生时最常进行手术的结构。内直肌是最常受伤的肌肉,其恢复无复视的功能性视力的预后最差。修复的最佳时机取决于受损的结构,但早期识别和处理似乎是这些损伤获得最佳结果的关键。