Temporalis Fascia for the Management of Medial Rectus Damage Secondary to Endoscopic Sinus Surgery: A Case Report

Purpose: To report a challenging case of medial rectus (MR) damage secondary to endoscopic sinus surgery (ESS). Methods: A 37‑year‑old woman presented with diplopia, exotropia, and adduction deficit of the right eye due to the right MR injury secondary to the ESS. Results: As a stepwise approach, she respectively underwent repairing of the damaged MR plus ipsilateral lateral rectus recession, half‑tendon vertical rectus transposition to the MR insertion, and eventually nasal globe fixation with temporalis fascia that ultimately provided a single vision in the primary position with orthophoria. Conclusions: Re‑establishment of an acceptable field of a single binocular vision in the context of iatrogenic MR injury is challenging and often requires multiple step‑wise operations. Temporalis fascia is a safe and strong autogenous material, which can be used for globe fixation in this setting.