Disinsertion of Inferior Oblique Muscle for Repair of Orbital Floor and Medial Wall Fracture Via Transcaruncular And Inferior Forniceal Approach-A Case Report

經內眥及下結膜穹窿施行內眼窩骨眼窩底骨折重建術後下斜肌脫位之後遺症－病例報告

陳欣怡(Shin-Yi Chen) ； 蔡悅如(Yueh-Ju Tsai) ； 馬俐(Lih Ma) ； 吳淑雅(Shu-Ya Wu) ； 褚晏彰(Yen-Chang Chu)

《中華民國眼科醫學會雜誌》 49卷4期 (2010/12) Pp. 610-615

https://doi.org/10.30048/ACTASOS.201012.0014

摘要

目的：報告一位病人經內眼窩骨及眼窩底骨折術後，因下斜肌脫位導致複視之併發症。
方法：一位三十一歲男性因右眼眼窩外破性骨折導致複視，接受經內眥及下結膜穹窿施行內眼窩骨併眼窩底骨折重建手術，術後因下斜肌脫位導致眼球內轉及影像傾斜之後遺症。術後以赫氏表(Hess chart)、眼基協調檢查(Comitance test)及馬氏複相檢查(Maddox rod test)追蹤。
結果：經過八個月的迫蹤，因下斜肌脫位造成之影像傾斜症狀仍持續。
結論：下斜肌脫位為經內眥施行內眼窩骨併眼窩底骨折重建手術之併發症之一。

並列摘要

Purpose: To report a patient who has the complication of diplopia due to disinsertion of inferior oblique muscle (IO) after repair of orbital floor and medial wall fracture with transcaruncular approach.
Methods: A 31-year-old male patient experienced blow-out fracture of the right eye with the presentation of diplopia, and received repair of orbital floor and medial wall with transcaruncular approach. Image tilting with right-eye intorsion was noted after operation. Results of a three-step test revealed right inferior oblique muscle underaction. We followed up the patient with Hess chart, comitance test and Maddox rod tests.
Results: Symptoms of image tilting due to underaction of the inferior oblique muscle persisted in the eight-month follow-up.
Conclusion: Persistent inferior oblique underaction is a possible complication of transcaruncular approach to orbital fracture repair.

並列關鍵字

Transcaruncular approach ； Inferior oblique muscle ； blow-out fracture