Abstract
Purpose
To present patients who suffered damage to the inferior oblique muscle branch of the oculomotor nerve during orbital fat decompression.
Methods
This study was a retrospective chart review of all patients who underwent orbital decompression surgery between April 2009 and June 2016 by the authors.
Results
Among 414 sides from 226 consecutive patients who underwent orbital decompression, the inferior oblique muscle branch was injured in two sides (0.5%) of two patients. Both patients showed hypotropia and incyclotropia immediately after surgery. Within 6 months of injury, ocular deviation on primary gaze had mostly resolved after conservative treatment. None of the patients underwent strabismus surgery. Postoperative computed tomographic images demonstrated that the affected branch was indistinct 3–4 mm posterior to the inferior oblique muscle.
Conclusions
This report indicates that injury to the inferior oblique muscle nerve branch can occur at a point posterior to the inferior oblique muscle during orbital fat decompression; however, the resulting ocular deviation improves considerably within 6 months of injury.
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Acknowledgements
Meeting Presentation Part of this study was presented at the 41th Orbital Society Meeting, Brisbane, September 2017.
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The authors have no conflicting interests related to this manuscript.
Human Participants and/or Animals; Informed consent
This study was approved by the Institutional Review Board (IRB) of our institution (2016-H273) and adhered to the 1964 Declaration of Helsinki tenets. The IRB granted a waiver of informed consent for this study based on the ethical guidelines for medical and health research involving human subjects established by the Japanese Ministry of Education, Culture, Sports, Science, and Technology and by the Ministry of Health, Labor, and Welfare. The waiver was granted since the study was a retrospective chart review, not an interventional study, and it would be difficult to obtain consent from patients who had been treated several years prior. Nevertheless, at the request of the IRB, we published an outline of the study, available for public viewing, on the Aichi Medical University website. This also provided patients the opportunity to decline participation; however, none of the patients declined to participate. Personal identifiers were removed from the records prior to data analysis.
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Takahashi, Y., Kakizaki, H. Damage to the inferior oblique muscle branch of the oculomotor nerve: a complication during orbital fat decompression. Int Ophthalmol 39, 711–716 (2019). https://doi.org/10.1007/s10792-018-0856-8
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DOI: https://doi.org/10.1007/s10792-018-0856-8