UNASSIGNED: The case records of two patients who presented with congenital enophthalmos and were discovered to have anomalous accessory orbital extraocular muscle bands were reviewed. The clinical features, initial diagnosis, high resolution magnetic resonance imaging (MRI) findings, and surgical outcomes were noted. A 3-dimensional reconstruction model was used to understand the approach and surgical management in one of the cases.
UNASSIGNED: Both patients presented with unilateral severe enophthalmos, globe retraction, and restricted ocular motility in all directions since birth. High-resolution MRI of the orbits revealed a short anomalous band, isointense to the muscle, arising from a rectus muscle belly and attaching to the posteroinferior part of the globe adjacent to the optic nerve. The caliber of the extraocular muscles and ocular motor nerves was normal. In one patient, surgery was not pursued due to the extreme posterior location of the band with proximity to the optic nerve. In the other patient, the deviation did not improve, despite successfully severing the accessory band, due to extensive scarring.
UNASSIGNED: Anomalous accessory orbital extraocular muscle bands are a rare and often overlooked cause of congenital enophthalmos when associated with limited ocular motility. Imaging the orbit can aid in diagnosis and help differentiate it from other causes. Safe surgical approaches to address the problem are limited, and available approaches may not be effective. These two cases highlight that the management of accessory extraocular muscle bands causing enophthalmos can be extremely challenging and difficult to improve even with intensive surgical intervention.
■回顾了2例先天性眼球内陷并被发现有异常的副眶眼外肌带的患者的病例记录。临床特征,初步诊断,高分辨率磁共振成像(MRI)发现,并记录了手术结果.在其中一种情况下,使用3维重建模型来了解方法和手术管理。
■两名患者均表现为单侧重度眼球内陷,地球仪收回,出生后各个方向的眼球运动受限.轨道的高分辨率MRI显示了一个短的异常带,肌肉等强度,由直肌腹部产生,并附着于视神经附近的眼球后下部分。眼外肌及眼运动神经口径正常。在一个病人中,由于带的位置非常靠后,靠近视神经,因此未进行手术。在另一个病人身上,偏差没有改善,尽管成功切断了配饰带,由于广泛的疤痕。
■异常的副眶眼外肌带是一种罕见且经常被忽视的先天性眼球内陷的原因,与有限的眼球运动有关。对轨道进行成像可以帮助诊断并帮助将其与其他原因区分开。解决该问题的安全手术方法有限,和可用的方法可能是无效的。这两种情况突出表明,即使采用密集的手术干预,导致眼球内翻的副眼外肌带的管理也可能极具挑战性,并且难以改善。