Special Surgical Procedures II LESSON 1: Eye, Ear, Nose, and Throat (EENT) Surgery
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1-11. PROCEDURES ON EXTRAOCULAR MUSCLES
a. General. Operations on muscles outside the eyeball are done for correction of strabismus. Strabismus is a term describing muscle imbalance between two eyes. An eye deviating outward or away from its fellow eye is a condition termed exotropia. If the eye deviates inward, it is termed esotropia.
b. Objective of Surgery.
c. Kinds of Operations. Strabismus may be treated surgically by procedures done either to strengthen weak muscles (refer to paragraphs 1-11d, e, and f below) or to weaken overactive muscles (refer to paragraphs g and h below).
d. Tucking. A tuck is sutured in the muscle, thus shortening it and increasing its effective strength.
e. Advancement. The muscle is freed at its attachment point, and it is reattached closer to the cornea, thus increasing its leverage.
f. Resection (Shortening). Part of the tendon of a extraocular muscle is excised. The muscle is reattached to the sclera at the original point of insertion.
g. Tenotomy. This is transection of the muscle sheath and tendon.
h. Recession (Lengthening). The muscle is detached from the eyeball and is sutured to the sclera posterior to the original insertion.
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