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  • Title: Botulinum toxin A therapy for medial rectus injury during endoscopic sinus surgery.
    Author: Hong JE, Goldberg AN, Cockerham KP.
    Journal: Am J Rhinol; 2008; 22(1):95-7. PubMed ID: 18284867.
    Abstract:
    BACKGROUND: Although the use of endoscopes and image guidance provide some safeguards, motility complications from orbital injury during endoscopic sinus surgery still pose a significant concern and can provide a therapeutic challenge. METHODS: We present the case of a 40-year-old woman with strabismus secondary to an iatrogenic injury to the medial rectus muscle during endoscopic sinus surgery. RESULTS: Permanent resolution of diplopia was achieved with botulinum toxin A injection into the lateral rectus muscle without the need for surgical intervention. CONCLUSION: Botulinum toxin A should be considered as a first-line early therapeutic option for cases of iatrogenically induced strabismus after endoscopic sinus surgery when complete transection or entrapment is not present.
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