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

Abbas Bagheri; Amirreza Veisi; Mehdi Tavakoli

doi:10.4103/joco.joco_108_20

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

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

Authors

Abbas Bagheri^{1

2}, Amirreza Veisi^{1

2}, Mehdi Tavakoli³

Affiliations

¹ Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
² Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Department of Ophthalmology and Visual Sciences, The University of Alabama at Birmingham, Callahan Eye Hospital, Birmingham, AL, USA.

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.

Keywords: Endoscopic sinus surgery; Globe fixation; Half-tendon vertical rectus transposition; Medial rectus injury; Temporalis fascia.

Publication types

Case Reports