Skip to main content
Erschienen in: International Ophthalmology 3/2019

08.02.2018 | Case Report

Damage to the inferior oblique muscle branch of the oculomotor nerve: a complication during orbital fat decompression

verfasst von: Yasuhiro Takahashi, Hirohiko Kakizaki

Erschienen in: International Ophthalmology | Ausgabe 3/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To present patients who suffered damage to the inferior oblique muscle branch of the oculomotor nerve during orbital fat decompression.

Methods

This study was a retrospective chart review of all patients who underwent orbital decompression surgery between April 2009 and June 2016 by the authors.

Results

Among 414 sides from 226 consecutive patients who underwent orbital decompression, the inferior oblique muscle branch was injured in two sides (0.5%) of two patients. Both patients showed hypotropia and incyclotropia immediately after surgery. Within 6 months of injury, ocular deviation on primary gaze had mostly resolved after conservative treatment. None of the patients underwent strabismus surgery. Postoperative computed tomographic images demonstrated that the affected branch was indistinct 3–4 mm posterior to the inferior oblique muscle.

Conclusions

This report indicates that injury to the inferior oblique muscle nerve branch can occur at a point posterior to the inferior oblique muscle during orbital fat decompression; however, the resulting ocular deviation improves considerably within 6 months of injury.
Literatur
1.
Zurück zum Zitat Ben Simon GJ, Wang L, McCann JD, Goldberg RA (2004) Primary-gaze diplopia in patients with thyroid-related orbitopathy undergoing deep lateral orbital decompression with intraconal fat debulking: a retrospective analysis of treatment outcome. Thyroid 14:379–383CrossRefPubMed Ben Simon GJ, Wang L, McCann JD, Goldberg RA (2004) Primary-gaze diplopia in patients with thyroid-related orbitopathy undergoing deep lateral orbital decompression with intraconal fat debulking: a retrospective analysis of treatment outcome. Thyroid 14:379–383CrossRefPubMed
2.
Zurück zum Zitat Lee KH, Jang SY, Lee SY, Yoon JS (2014) Graded decompression of orbital fat and wall in patients with Graves’ orbitopathy. Korean J Ophthalmol 28:1–11CrossRefPubMedPubMedCentral Lee KH, Jang SY, Lee SY, Yoon JS (2014) Graded decompression of orbital fat and wall in patients with Graves’ orbitopathy. Korean J Ophthalmol 28:1–11CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Serafino M, Fogagnolo P, Trivedi RH, Saunders RA, Nucci P (2010) Torsional diplopia after orbital decompression and strabismus surgery. Eur J Ophthalmol 20:437–441CrossRefPubMed Serafino M, Fogagnolo P, Trivedi RH, Saunders RA, Nucci P (2010) Torsional diplopia after orbital decompression and strabismus surgery. Eur J Ophthalmol 20:437–441CrossRefPubMed
4.
Zurück zum Zitat Garrity JA, Saggau DD, Gorman CA, Bartley GB, Fatourechi V, Hardwiq PW, Dyer JA (1992) Torsional diplopia after tranantral orbital decompression and extraocular muscle surgery associated with Graves’ orbitopathy. Am J Ophthalmol 113:363–373CrossRefPubMed Garrity JA, Saggau DD, Gorman CA, Bartley GB, Fatourechi V, Hardwiq PW, Dyer JA (1992) Torsional diplopia after tranantral orbital decompression and extraocular muscle surgery associated with Graves’ orbitopathy. Am J Ophthalmol 113:363–373CrossRefPubMed
5.
Zurück zum Zitat Tsutsumi S, Nakamura M, Tabuchi T, Yasumoto Y, Ito M (2013) An anatomic study of the inferior oblique nerve with high-resolution magnetic resonance imaging. Surg Radiol Anat 35:377–383CrossRefPubMed Tsutsumi S, Nakamura M, Tabuchi T, Yasumoto Y, Ito M (2013) An anatomic study of the inferior oblique nerve with high-resolution magnetic resonance imaging. Surg Radiol Anat 35:377–383CrossRefPubMed
6.
Zurück zum Zitat Richter DF, Stoff A, Olivari N (2007) Transpalpebral decompression of endocrine ophthalmopathy by intraorbital fat removal (Olivari technique): experience and progression after more than 3000 operations over 20 years. Plast Reconstr Surg 120:109–123CrossRefPubMed Richter DF, Stoff A, Olivari N (2007) Transpalpebral decompression of endocrine ophthalmopathy by intraorbital fat removal (Olivari technique): experience and progression after more than 3000 operations over 20 years. Plast Reconstr Surg 120:109–123CrossRefPubMed
7.
Zurück zum Zitat Trokel S, Kazim M, Moor S (1993) Orbital fat removal: decompression for Graves orbitopathy. Ophthalmology 100:674–682CrossRefPubMed Trokel S, Kazim M, Moor S (1993) Orbital fat removal: decompression for Graves orbitopathy. Ophthalmology 100:674–682CrossRefPubMed
8.
Zurück zum Zitat O’Malley MR, Meyer DR (2009) Transconjunctival fat removal combined with conservative medial wall/floor orbital decompression for Graves orbitopathy. Ophthal Plast Reconstr Surg 25:206–210CrossRefPubMed O’Malley MR, Meyer DR (2009) Transconjunctival fat removal combined with conservative medial wall/floor orbital decompression for Graves orbitopathy. Ophthal Plast Reconstr Surg 25:206–210CrossRefPubMed
9.
Zurück zum Zitat Takahashi Y, Sabundayo MS, Miyazaki H, Mito H, Kakizaki H (2017) Incarceration of the inferior oblique muscle branch of the oculomotor nerve in patients with orbital floor trapdoor fracture. Graefe Arch Clin Exp Ophthalmol 255:2059–2065CrossRef Takahashi Y, Sabundayo MS, Miyazaki H, Mito H, Kakizaki H (2017) Incarceration of the inferior oblique muscle branch of the oculomotor nerve in patients with orbital floor trapdoor fracture. Graefe Arch Clin Exp Ophthalmol 255:2059–2065CrossRef
10.
Zurück zum Zitat Takahashi Y, Kakizaki H, Kohjima K, Nakano T, Asamoto K, Ichinose A, Iwaki M (2013) Inferior oblique muscle origin: horizontal location in relation to ala nasi and its gender difference. Ann Plast Surg 70:88–90CrossRefPubMed Takahashi Y, Kakizaki H, Kohjima K, Nakano T, Asamoto K, Ichinose A, Iwaki M (2013) Inferior oblique muscle origin: horizontal location in relation to ala nasi and its gender difference. Ann Plast Surg 70:88–90CrossRefPubMed
Metadaten
Titel
Damage to the inferior oblique muscle branch of the oculomotor nerve: a complication during orbital fat decompression
verfasst von
Yasuhiro Takahashi
Hirohiko Kakizaki
Publikationsdatum
08.02.2018
Verlag
Springer Netherlands
Erschienen in
International Ophthalmology / Ausgabe 3/2019
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-018-0856-8

Weitere Artikel der Ausgabe 3/2019

International Ophthalmology 3/2019 Zur Ausgabe

Neu im Fachgebiet Augenheilkunde

Ophthalmika in der Schwangerschaft

Die Verwendung von Ophthalmika in der Schwangerschaft und Stillzeit stellt immer eine Off-label-Anwendung dar. Ein Einsatz von Arzneimitteln muss daher besonders sorgfältig auf sein Risiko-Nutzen-Verhältnis bewertet werden. In der vorliegenden …

Operative Therapie und Keimnachweis bei endogener Endophthalmitis

Vitrektomie Originalie

Die endogene Endophthalmitis ist eine hämatogen fortgeleitete, bakterielle oder fungale Infektion, die über choroidale oder retinale Gefäße in den Augapfel eingeschwemmt wird [ 1 – 3 ]. Von dort infiltrieren die Keime in die Netzhaut, den …

Bakterielle endogene Endophthalmitis

Vitrektomie Leitthema

Eine endogene Endophthalmitis stellt einen ophthalmologischen Notfall dar, der umgehender Diagnostik und Therapie bedarf. Es sollte mit geeigneten Methoden, wie beispielsweise dem Freiburger Endophthalmitis-Set, ein Keimnachweis erfolgen. Bei der …

So erreichen Sie eine bestmögliche Wundheilung der Kornea

Die bestmögliche Wundheilung der Kornea, insbesondere ohne die Ausbildung von lichtstreuenden Narben, ist oberstes Gebot, um einer dauerhaften Schädigung der Hornhaut frühzeitig entgegenzuwirken und die Funktion des Auges zu erhalten.   

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.