Endoscopic ocular muscle surgery

Ocular muscle surgery is traditionally performed via an anterior, open approach. Excessive dissection within the orbit can lead to fat adherence syndrome. In cases of restrictive strabismus with severe esotropia, the medial rectus rotates to the posterior orbit, making surgery increasingly challenging. Endoscopic sinus surgery has progressed to include procedures in areas adjacent to the sinuses. The orbit, in particular the medial rectus muscle, is particularly suitable for transnasal endoscopic surgery. Situations that could benefit from this technique include strabismus surgery and posttraumatic exploration of the medial rectus. This article describes the authors' approach to endoscopic ocular muscle surgery.