Autogenous fascia augmentation of a partially extirpated muscle with a subperiosteal medial orbitotomy approach.

INTRODUCTION Endoscopic sinus surgery can result in serious extraocular muscle dysfunction. The medial rectus muscle is more frequently affected than other extraocular muscles. METHODS A transconjunctival subperiosteal medial orbitotomy was successful in retrieving a partially extirpated medial rectus muscle after endoscopic sinus surgery. RESULTS A previous attempt to localize this muscle by conventional surgery with extensive exploration was unsuccessful. A Hummelsheim procedure was also abandoned after a rupture of the nasal aspect of the inferior rectus muscle occurred. CONCLUSION The approach we describe allowed adequate visualization of the posterior orbital content, as well as adequate space for suture placement.