Extraocular Muscle Injury

Extraocular muscle injury is a rare but potentially devastating complication of endoscopic sinus surgery. Preoperative analysis of the patient’s CT will help the surgeon to form a mental roadmap of the planned surgery, while also identifying anatomic features and “danger zones” that may lead to increased risk of injury. Intraoperative strategies to mitigate injury including careful, meticulous dissection of the lamina papyracea using proper techniques with both hand instruments as well as microdebriders further reduce risk. Control of intraoperative bleeding in the surgical field is also critical to injury prevention. Employing these strategies will help to reduce the risks to the patient, even in the setting of distorted anatomy and advanced disease.