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Orbital Injury With Medial Rectus Tear and Cerebrospinal Fluid Leak Following Functional Endoscopic Sinus Surgery: A Case Report

Year: 2026

Type: article

Abstract: Functional endoscopic sinus surgery (FESS) is widely used as a safe and effective treatment for paranasal sinus disorders.However, complications may occur because of the close anatomical relationship between the paranasal sinuses, orbit, and skull base.We report a 32-year-old man with hypertension, diabetes mellitus, and hypercholesterolemia whose earlier FESS had been complicated by left orbital injury with a medial rectus muscle tear.Postoperatively, he developed persistent severe headache requiring daily analgesics, together with restricted motility of the left eye, diplopia, and proptosis, and underwent medial rectus repair four months later.He subsequently developed unilateral left-sided rhinorrhea.Computed tomography demonstrated defects of the left lamina papyracea and thinning of the left lateral lamella, and a cerebrospinal fluid (CSF) leak was suspected despite a magnetic resonance imaging CSF protocol showing no definite leak.Approximately 19 months after the initial surgery, he underwent navigation-guided revision left FESS, which confirmed defects of the lamina papyracea and cribriform plate; the skull base defect was repaired with a nasal floor overlay graft.Following surgery, the headache resolved, with no rhinorrhea, no bleeding, intact vision, and no diplopia.At seven months of follow-up, the patient remains well with no complaints.

Source: Cureus

DOI: 10.7759/cureus.119285

Authors: Omar Altawash, Lulwah Al Saidan, Mariam Alshammari, Marwan Al-Qunaee

Institution: Kuwait Institute for Medical Specialization

Language: English

Topic: Facial Trauma and Fracture Management

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7225459428