Conventional strabismus surgery employs a conjunctival incision to gain access 
to Tenon's space where a wide variety of procedures are routinely performed on 
the tendon and anterior aspect of the extraocular muscles. Recently, transnasal 
endoscopic surgical techniques have gained acceptance as effective means of 
decompressing the medial wall and floor of the orbit in patients with 
thyroid-related orbitopathy. The orbital surface of the medial rectus and 
inferior rectus are exposed from the annulus of Zinn to a position close to 
where the muscles penetrate Tenon's capsule. In theory, this technique also 
provides the exposure necessary to locate and retrieve a "lost" medial rectus 
when the usual sub-Tenon's approach fails to recover the muscle. Cadaver studies 
demonstrate the feasibility of exposure and suture placement in the stump of a 
lost medial rectus with passage of the suture through Tenon's capsule to 
transmit the force of the muscle to the globe, provided that the lost muscle is 
retrieved before severe contracture develops.