Work

Orbital Floor Fracture With Haller Cells and Inferior Rectus Injury Post-Endoscopic Sinus Surgery

Year: 2025

Type: article

Abstract: A 27-year-old male developed diplopia and gaze limitation after endoscopic sinus surgery (ESS) due to an iatrogenic inferior rectus (IR) muscle injury caused by an orbital floor fracture involving Haller cells. Preoperative CT and MRI confirmed this injury. Intraoperatively, a fracture and soft tissue herniation were found and their reduction improved upward extraocular movement (EOM), although downward EOM remained limited. Although initial postoperative improvement was observed, at the 1-year follow-up, the patient showed overall recovery compared with the initial injury but declined from the immediate postoperative state, likely due to muscle injury-induced paralysis. Hence, facial bone surgeons should consider both orbital wall fractures and rectus muscle injuries when a patient presents with diplopia after ESS. Preoperative imaging, such as CT or MRI, is essential. IR muscle injury can lead to IR palsy, potentially resulting in an initially improved postoperative condition but a less favorable long-term prognosis.

Source: Journal of Craniofacial Surgery

DOI: 10.1097/scs.0000000000011410

Authors: Jeeyoon Kim, Jihyoung Chang, Eun Young Rha

Institutions: Catholic University of Korea, The Catholic University of Korea Eunpyeong St. Mary's Hospital

Language: English

Topic: Facial Trauma and Fracture Management

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Funders: National Research Foundation, National Research Foundation of Korea, Ministry of Science and ICT, South Korea