• The Korean Journal of Physiology
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• v.21 no.1
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• pp.91-101
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• 1987

The present experiment was carried out, in the rabbit and cat, in order to explore functional interrelationship between the vestibular semicircular canals and extraocular muscles, which are involved in the vestibulooculomotor reflex as the receptor and effector organ respectively. Semicircular canals were subjected to electrical stimulation, lymphatic fluid flow or acute freezing, and responses of the extraocular muscles were recorded in terms of changes in electromyographic activity and isometric tension. Electrical stimulation of a unilateral canal elicited contraction of the superio-medial muscle group (superior oblique, superior rectus and medial rectus muscles) in the ipsilateral eye and the inferio-lateral muscle group (inferior oblique, inferior rectus and lateral rectus muscles) in the contralateral eye. Thus a simple and distinct axiom was found in the pattern of the reflex-response of the extraocular muscles. Inhibition of the unilateral canals elicited the extraocular muscle responses contrary to those observed by excitation of the canal. Based on the present experimental results, it was demonstrated that the functional interrelations between the semicircular canals and extraocular muscles are rather equivalent in the frontal eyed cats (with binocular vision) and lateral eyed rabbits (with monocular vision). Therefore the previous thesis that the vestibuloocular relations vary from species to species awaits experimental reevaluation.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.879-882
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• 2011

Purpose: Superior orbital fissure syndrome is a rare neurological complex. Superior orbital fissure syndrome may result from a variety of inflammatory, infectious, neoplastic, iatrogenic, traumatic, vascular cause. The author report a patient who suffered from superior orbital fissure syndrome after inferior orbital wall reduction. Methods: A 26-year-old female suffered from inferior orbital wall fracture with inferior gaze limitation and orbital soft tissue herniation. On posttrauma 10 day, inferior orbital wall was reduced using endoscope and porous polyethylene ($Medpor^{(R)}$) was inserted. On immediate postoperation, she reported that extraocular movement was limited in almost any directions. She underwent exploration surgery to release the presence of extraocular muscle impingement. But, there was no observation of extraocular muscle impingement. On postoperative one day, high-dose steroid therapy was started to release superior orbital fissure syndrome which was defined in postoperative computed tomography. Results: After one month of high-dose steroid therapy, extraocular movement limitations improved progressively in all directions. In four months, extraocular movement recovered completely. Conclusion: Superior orbital fissure syndrome may occur after surgical procedure of orbital wall reduction. Prompt diagnosis and treatment with mega-dose corticosteroid is an effective option for avoiding disaster from compressive syndrome.

• The Korean Journal of Physiology
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• v.16 no.1
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• pp.31-40
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• 1982

The present experiment was carried out to elucidate interrelation between the vestibular canals and the extraocular oblique muscles. In urethane anesthetized rabbits, excitatory or inhibitory effect of the canal was produced by three different methods; selective electrical stimulation of the ampullary nerve, bidirectional (ampullofugal or ampullopetal) lymphatic fluid flow, and rapid freezing of the canal. Changes of isometric tension as well as electro-myographic activity of the oblique muscles were recorded in the ipsilateral and contralateral eyes, by means of a polygraphic recorder, and the following results were obtained. 1) Electrical stimulation of a unilateral vertical or horizontal nerve caused contraction of superior oblique muscle and relaxation of inferior oblique muscle in the ipsilateral eye, and contraction of inferior oblique muscle and relaxation of superior oblique muscle in the contralateral eye. 2) Ampullofugal flow in a vertical canal and ampullopetal flow in a horizontal canal caused the oblique muscle responses which were identical to those responses produced by the electrical stimulation of the same canal nerve. 3) Rapid freezing of a vertical canal elicited the oblique muscle responses which were opposite to those caused by electrical stimulation of the same canal nerve. From the above experimental results, functional interrelation between the individual vestibular canal and bilateral extraocular oblique muscles were better elucidated. When these results were compared to those reported by previous investigators (Utzumi, Suzuki et al.), some important discrepancies were found between them. We ascribed such discrepancies to experimental errors of the previous investigators, since their results reflected theoretical contradictions in terms of vestibular eye movements.

• Archives of Craniofacial Surgery
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• v.24 no.3
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• pp.133-138
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• 2023

White-eyed blowout fractures with extraocular muscle (EOM) entrapment necessitate emergency surgical intervention. However, even after surgery, diplopia or EOM motion limitations may persist due to the incomplete reduction of soft tissue herniation caused by inadequate dissection or unresolved muscle strangulation. In this report, we present a case of postoperative EOM movement limitation in a 5-year-old girl who experienced recurrent restriction in the upward gaze of her right eye 14 days after surgery. Instead of revision surgery, the patient was treated with targeted EOM exercises focusing on the inferior rectus muscle and inferior oblique muscle. The patient was instructed to slowly move her pupils from the central point to the upper and outer sides, then in a straight line from the central point to the lower and inner sides before returning to the center point. On the 28th postoperative day, 2 weeks after initiating the exercises, the patient's EOM motion fully recovered. This case highlights the effectiveness of EOM exercises as a non-surgical treatment approach for improving recurrent EOM movement limitations in the absence of soft tissue herniation following surgical management of blowout fractures in children.

• Journal of Physiology & Pathology in Korean Medicine
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• v.17 no.1
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• pp.247-250
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• 2003

Objectives : Strabismus refers to the muscle imbalanced that results from improper alignment of the visual axes of the two eyes. It may be divided into paralytic and nonparalytic strabismus. Paralytic strabismus is primarily result from neurologic problem and nonparalytic strabismus is more strictly opthalmologic problem. We try to improve the remedial value of acute paralytic strabismus. Methods : We treated the cases by use of electra-acupuncture at paralytic extraocular muscles. The cases were treated almost daily and every treatment were enforced 10 minutes. We use the PG-306 electra-acupuncture products(Suzuki Iryoki Co. Japan) and apply the low consequence wave of 1-8Hz Results : We found that two cases were recovered almost three months and one case is treated till now and improved. So we try to apply this treatment in many cases and make the treating protocol of acute paralytic strabismus.

• Archives of Craniofacial Surgery
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• v.13 no.2
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• pp.130-134
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• 2012

Purpose: Brown syndrome is motility disorder of the eyeball which shows limited elevation in adduction and occurs very rarely after eye surgery. The authors have experienced a case of strabismus-like Brown syndrome combined with blepharoptosis and report this case with the review of literatures. Methods: A 28-year-old female suffered from hypotropia in the primary gaze and severe blepharoptosis with diplopia of the right eye after upper blepharoplasty. Rotation showed an inability to elevate the adducted right eye. She underwent extraocular muscle surgery about the 7 mm tucking of the right superior rectus muscle and 6 mm recession of right inferior rectus muscle. Intraoperatively, injury of the superior rectus muscle and foreign body were observed. Seven months after the extraocular surgery, the patient underwent frontalis muscle transfer on the right upper eyelid for the correction of blepharoptosis. Results: Postoperatively, the patient was orthophoric in the primary gaze, and she had improvements in the correction of blepharoptosis and eyeball movement. Conclusion: Repeated eyelid surgeries increase the risk of ocular motility disorder. Careful approach is essential for the proper treatment and successful outcome in secondary surgeries.

• The Korean Journal of Physiology
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• v.4 no.1
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• pp.59-67
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• 1970

In recent observations on vestibular eye movements in mammals, reported by several different workers, it was indicated that the pattern of reflex eye movement from semicircular canal nerve stimulation in rabbits was different from that observed in the other species such as cats and dogs. Observing the different anatomical features of the extraocular muscles of rabbits, Kim ascribed the different pattern of eye movement of rabbits to the functional difference of inferior and superior oblique muscles from those of other species. Present experiment was carried out to elucidate a physiological mechanism underlying in such particular pattern of reflex eye movement in rabbits. An individual canal nerve was selectively stimulated, under a dissecting microscope, by a fine electrode induced into an ampulla through a hole provided on the wall of corresponding osseous canal, and responses of the extraocular muscles were checked by recording the isotonic changes of muscle length. Following results were obtained. 1. Direct stimulation of the superior or inferior oblique muscles Produced upward or downward movement of the eye turning toward medial side respectively. 2. Stimulation of the unilateral canal nerve Produced a marked contraction of a main contracting ocular muscle and simultaneous relaxation of an antagonistic muscle in both eyes. Less potent contraction of an additional ocular muscle was observed and it appeared to augment the function of the main contracting muscle in the ipsilateral eye. 3. Stimulation of superior semicircular canal nerve caused a primary contraction of superior rectus, synergic contraction of superior oblique and relaxation of inferior rectus in ipsilateral eye. Contraction of inferior oblique and relaxation of superior oblique were observed in the contralateral eye. 4. Stimulation of lateral semicircular canal nerve produced a primary contraction of medial rectus, synergic contraction of superior oblique and relaxation of lateral rectus in the ipsilateral eye. Contraction of lateral rectus and relaxation of medial rectus were observed in the contralateral eye. 5. Stimulation of inferior semicircular canal nerve produced a primary contraction of superior oblique, synergic contraction of superior rectus and relaxation of inferior oblique in the ipsilateral eye. Contraction of. inferior rectus and relaxation of superior rectus were observed in the contralateral eye. 6. Upon stimulation of individual canal nerve, the pattern of eye movement in rabbits is different from those of cats, however, the responses of the extraocular muscles appear to be similar in two species. Therefore, it is concluded that the different Pattern of eye movement in both species are not due to the possible difference of vestibule-ocular reflex pathways but to the functional difference of superior and inferior oblique muslces.

• The Korean Journal of Physiology
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• v.8 no.2
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• pp.1-17
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• 1974

This experiment was designed to explore the specific functional interrelations between the vestibular semicircular canals and the extraocular muscles which may disclose the neural organization, connecting the vestibular canals and each ocular motor nuclei in the brain system, for vestibuloocular reflex mechanism. In urethane anesthetized rabbits, a fine wire insulated except the cut cross section of its tip was inserted into the canals closely to the ampullary receptor organs through the minute holes provided on the osseous canal wall for monopolar stimulation of each canal nerve. All extraocular muscles of both eyes were ligated and cut at their insertio, and the isometric tension and EMG responses of the extraocular muscles to the vestibular canal nerve stimulation were recorded by means of a physiographic recorder. Upon stimulation of the semicircular canal nerve, direction if the eye movement was also observed. The experimental results were as follows. 1) Single canal nerve stimulation with high frequency square waves (240 cps, 0. 1 msec) caused excitation of three extraocular muscles and inhibition of remaining three muscles in the bilateral eyes; stimulation of any canal nerve of a unilateral labyrinth caused excitation (contraction) of the superior rectus, superior oblique and medial rectus muscles and inhibition (relaxation) of the inferior rectus, inferior oblique and lateral rectos muscles in the ipsilateral eye, and it caused the opposite events in the contralateral eye. 2) By the overlapped stimulation of triple canal nerves of a unilateral labyrinth, unidirectional (excitatory or inhibitory) summation of the individual canal effects on a given extraocular muscles was demonstrated, and this indicates that three different canals of a unilateral vestibular system exert similar effect on a given extraocular muscles. 3) Based on the above experimental evidences, a simple rule by which one can define the vestibular excitatory and inhibitory input sources to all the extraocular muscles is proposed; the superior rectus, superior oblique and medial rectus muscles receive excitatory impulses from the ipsilateral vestibular canals, and the inferior rectus, inferior oblique and lateral rectus muscles from the contralateral canals; the opposite relationship applies for vestibular inhibitory impulses to the extraocular muscles. 4) According to the specific direction of the eye movements induced by the individual canal nerve stimulation, an extraocutar muscle exerting major role (a muscle of primary contraction) and two muscles of synergistic contraction could be differentiated in both eyes. 5) When these experimental results were compared to the well known observations of Cohen et al. (1964) made in the cats, extraocular muscles of primary contraction were the same but those of synergistic contraction were partially different. Moreover, the oblique muscle responses to each canal nerve excitation appeared to be all identical. However, the responnes of horizontal (medial and lateral) and vertical (superior and inferior) rectus muscles showed considerable differences. By critical analysis of these data, the author was able to locate theoretical contradictions in the observations of Cohen et al. but not in the author's results. 6) An attempt was also made to compare the functional observation of this experiment to the morphological findings of Carpenter and his associates obtained by degeneration experiments in the monkeys, and it was able to find some significant coincidence between there two works of different approach. In summary, the author has demonstrated that the well known observations of Cohen et al. on the vestibulo-ocular interrelation contain important experimental errors which can he proved by theoretical evaluation and substantiated by a series of experiments. Based on such experimental evidences, a new rule is proposed to define the interrelation between the vestibular canals and the extraocular muscles.

• Investigative Magnetic Resonance Imaging
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• v.15 no.2
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• pp.176-180
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• 2011

Metastases to the orbit usually affect the intraorbital fat and bone than the extraocular muscles. Metastasis to the extracoular muscles commonly occurs unilaterally, and diffuse enlargement of the bilateral extraocular muscles due to metastasis is extremely rare. In this report, we will describe a case of diffuse metastasis to the bilateral extraocular muscles from nasal rhabdomyosarcoma masquerading as thyroid associated orbitopathy. We will also discuss about the MR imaging findings helpful for differential diagnosis from thyroid associated orbitopathy.

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.44-51
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• 2007

Purpose: Blow-out fracture is one of the most common fractures in facial trauma. It is diagnosed by Computed Tomography(CT) scan, which is considered as the most effective diagnostic tool. Since, the Picture Archiving Communication System(PACS) has been provided recently to many hospitals, doctors are more familiar with imaging software of PACS. Because this software has many useful measuring tools, doctors can measure orbital structure easily and make a plan for treatment with its data. Therefore, authors intended to analyze the data of orbital structure measured with PACS imaging software and evaluate its usefulness. Methods: The charts and CT images of 100 patients, which were 50 patients with medial wall fracture and 50 patients with floor fracture, were reviewed. Patients were selected by pre-determined criteria and their CT images were measured with image software of PACS. 'Extraocular muscle thickness', 'Defect ratio'(ratio of defect area to normal area) and 'Globe position index' were measured and analyzed statistically. Results: The thickness of inferior rectus muscle and medial rectus muscle was simultaneously increased in acute-stage of blow-out fracture. The medial rectus muscle was more thickened in medial wall fracture and inferior rectus was more thickened in floor fracture, respectively. In acute blow-out fracture, globe position is exophthalmic rather than enophthalmic. Especially in floor fracture, numerical value summed up thickness of all extraocular muscle is correlated to the defect ratio and globe position index. Conclusion: Clinicians can decide globe position or presume defect ratio in inferior wall fracture by measurement of CT image in acute blow-out fracture using PACS.