PMC6051265_01
Frontal photograph during superior gaze. Limitation of left superior gaze.
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fig1
Examination revealed restriction of superior gaze of the left eye (Figure 1).
CT scan of the sinuses without contrast, frontal view. 5 mm defect in the posterior medial orbital floor with inferior displacement of the inferior rectus muscle into the defect. Soft tissue band was present from the defect to the remnant of the uncinate process (arrow).
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fig2
A CT scan revealed a 5 mm defect in the posterior medial orbital floor with inferior displacement of the inferior rectus muscle into the defect (Figure 2).
Endoscopic view of left nasal cavity (a) and orbital floor (b). MT, middle turbinate. Arrow denotes scar band tethering the inferior rectus muscle to the sinus mucosa through the defect on the orbital floor (OF).
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fig3
Intraoperatively, there was a thick scar band tethering the inferior rectus muscle to the sinus mucosa through the defect on the orbital floor (Figure 3).
Endoscopic view of the left nasal cavity after revision ESS and uncinectomy. Bulging in nasal mucosa when instrumented through the orbital defect (arrow). LP,  lamina papyracea.
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fig4
From the nasal perspective, there was healthy sinonasal mucosa over the defect, but bulging of that mucosa could be seen when instrumented through the orbit (Figure 4).