Microscopic Adhesiolysis for Inferior Rectus Muscle Entrapment in a Chronic Orbital Floor Trapdoor Fracture
Author: Akira Ishida
Base Hospital / Institution: Oculofacial Clinic Group
ePoster presentation
Abstract ID: 25-501
Purpose
To report a case of chronic orbital floor trapdoor fracture with persistent ocular motility restriction after surgery somewhere successfully treated using microscopic adhesiolysis of the inferior rectus muscle.
Methods
A 12-year-old girl sustained a right orbital floor trapdoor fracture due to trauma and underwent surgical repair at another hospital the day after the injury. Despite the initial surgery, vertical diplopia and significant upgaze limitation persisted. She was referred to our institution 40 days postoperatively. Revision surgery was performed on postoperative day 53 using a surgical microscope (Leica M320). Intraoperatively, dense fibrotic tissue adherent to the surface of the inferior rectus muscle was carefully dissected and removed. There was no evidence of ongoing entrapment at the fracture site.
Results
At the three-month follow-up, the patient demonstrated marked improvement in upward gaze and resolution of vertical diplopia. There were no intraoperative or postoperative complications.
Conclusion
In chronic cases of orbital floor trapdoor fracture, particularly when surgical intervention is delayed, fibrosis around the inferior rectus muscle can significantly impair recovery. Microscopic adhesiolysis allows for precise dissection of perimuscular scar tissue and may result in substantial functional improvement. This technique may serve as a valuable option in selected chronic cases with persistent ocular motility dysfunction.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Tomoyuki | Kashima | Oculofacial Clinic Group |
