Ethmoidectomy via endoscopic technique

With 4-7 cases of Rhinonasal polypsis in Eto-rhino-laryngologic center, from January 1998 to January 2001, in the age of 16-60 years. The ethmoidectomy via endoscopic technique and receive high efficacy result: 97% decrease nasal obstruction post op, 0% of orbital and intracranial complications, and specially 27% has appeared the minimal recurrent polyps on the anterior ethmoid which did not remove, just only use the steroid spray. Preparing the pre-op period with antibiotic, anti-inflammatory 93.7% and planned regularly patient's examination each month per year. Others factors such as asthma 13%, allergic zhinitis 24%, tobacco 15% were well studied to improve the result of the endoscopic ethmoidectomy and to limit the recurrent polyps

A Case of Medial Rectus Muscle Injury after Functional Endoscopic Sinus Polypectomy and Ethmoidectomy

PURPOSE: To report appropriate treatment of medial rectus muscle injury after functional endoscopic sinus polypectomy and ethmoidectomy METHODS: The author experienced the right medial rectus muscle injury after functional endoscopic polypectomy and ethmoidectomy in a 42-year-old man who complained of decreased visual acuity, ocular pain, binocular diplopia, and exophthalmos in the right eye at the first postoperative day. His best corrected visual acuity of right eye was 0.3, Intraocular pressure was 26 mmHg, and pupillary light reflex was decreased. On exophthalmometry, the right eye was more exophthalmic by 3 mm than the left eye. After steroid therapy and befunolol eyedrops instillation, the visual acuity was improved to 0.8 and intraocular pressure was decreased to 18 mmHg. There was severe limitation of medial gaze and about 65 prism diopters of right exodeviation in red filter test. In computerized tomography, bony defect in the right orbital medial wall and defect in the right medial rectus muscle were confirmed. On the third postoperative day, silastic sheet was applied in dehiscent medial wall under endoscopic examination in otorhinolaryngologic outpatient department. Because exodeviation and diplopia had not improved, on the 61th postoperative day, right lateral rectus muscle recession 12 mm was carried out, and then, on the 88th postoperative day, Hummelsheim operation on right eye was done. RESULTS: Right exodeviation was decreased by about 40 prism diopters after right lateral rectus muscle recession 12 mm. and then, after Hummelsheim operation, he had right exodeviation 20 prism diopters of and less binocular diplopia. We prescribed 10 prism diopters of prism lens in each eye, but he complained of decreased visual acuity and cosmetic problem. So, we prescribed 5 prism diopters of prism lens in each eye. At the last follow-up he is satisfied with his visual acuity and cosmetic aspect.

A Case of Central Retinal Artery Occlusion after Intranasal Ethmoidectomy

The authors experienced a case of 54 years old female patient who had sudden loss of vision in her right eye following intranasal ethmoidectomy. The computer tomography of orbit showed that RMR muscle was entrapped to medial orbital wall and optic nerve was strained and deviated to medial wall. The fluorescein angiogram showed central retinal artery occlusion (CRAO) in that eye.

A Case of Central Retinal Artery Occlusion after Intranasal Ethmoidectomy

The authors experienced a case of 54 years old female patient who had sudden loss of vision in her right eye following intranasal ethmoidectomy. The computer tomography of orbit showed that RMR muscle was entrapped to medial orbital wall and optic nerve was strained and deviated to medial wall. The fluorescein angiogram showed central retinal artery occlusion (CRAO) in that eye.

Treatment of Medial Orbital Wall Fracture Using Endoscopic Intranasal Ethmoidectomy

An isolated blow out fracture of the medial orbital wall is uncommon, where as the incidence of conjugation with an orbital floor fracture is high. Clinically, they are suspected when periorbital trauma is associated with epistaxis, orbital hematoma, subcutaneous emphysema and horizontal diplopia. Surgical intervention is indicated if the fracture cause impairment of ocular motility, diplopia and enophthalmos due to incarceration of medial rectus muscle and soft tissue. Recently, endoscopic surgery in the treatment of orbital wall fracture instead of external approach has been introduced. The authors performed endoscopic intranasal ethmoidectomy with release of the rectus muscle in two patients with medial orbital wall fracture on the first post-traumatic day in one and the thirteenth day in the other and have good result.

Case Report of Blindness After Intranasal Ethmoidectomy

Surgical extirpation and drainage of the paranasal sinus is frequently used by the otolaryngologist in the management of allergic, infectious, and neoplastic sinus diseases. Several surgical approaches to the ethmoid and maxillary sinuses, including ethmoidectomy and Caldwell-Luc's operation, may be used. In the intranasal approach to ethmoidectomy, the lamina papyracea, the thin partition separating the periorbita from the ethmoid sinus. cannot be directly visualized during this procedure and may be perforated inadvertently. Endoscopic nasal sinus surgery has only recently been introduced into Korea. This rather novel technique, especially when used by less-experienced surgens, has major complications similar to what has been reported with the traditional intranasal sphenoethmoidectomy. Even then, major complications may occur in the hands of very experienced surgeons. The ophthalmolgist may be consulted in the management of patients with orbital complications of sinus surgery. We present one patient with ophthalmic complications of sinus surgery encountered by the authors. The purpose of this report is to present to the ophthalmologist examples of orbital complications that may arise from sinus surgery, and treatment options.

A Case of Ethmoid Sinus Mucocele with Transient Intraocular Pressure Elevation

The ethmoid mucocele, resulting in the proptosis, is known a rare benign lesion. There are a number of ophthalmic manifestations of cystic lesion arising from the ethmoid sinus, which has destroyed the lamina papyracea and invaded the orbit. It is demonstrated by simple orbit X-ray and orbit CT scan. We experienced a case of a ethmoid mucocele in a 36-year-old man. which was associated with frontalgia, proptosis and transient intraocular pressure elevation and was improved after intranasal ethmoidectomy.