Superior Rectus Muscle Recession for Residual Head Tilt after Inferior Oblique Muscle Weakening in Superior Oblique Palsy
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Purpose: Residual head tilt has been reported in patients with superior oblique muscle palsy (SOP) after surgery to weaken the inferior oblique (IO) muscle. The treatments for these patients have not received appropriate attention. In this study, we evaluated the superior rectus (SR) muscle recession as a surgical treatment. Methods: The medical records of 12 patients with SOP were retrospectively reviewed. Each of these patients had unilateral SR muscle recession for residual head tilt after IO muscle weakening due to SOP. The residual torticollis was classified into three groups on the basis of severity: mild, moderate, or severe. Both IO muscle overaction and vertical deviation, features of SOP, were evaluated in all patients. The severity of the preoperative and postoperative torticollis and vertical deviation were compared using a paired t-test and Fisher’s exact test. Results: The torticollis improved in nine of 12 (75%) patients after SR muscle recession. The difference between the preoperative and postoperative severity of torticollis was statistically significant (p = 0.0008). After surgery, the mean vertical deviation was significantly reduced from 12.4 prism diopters to 1.3 prism diopters (p = 0.0003). Conclusions: Unilateral SR muscle recession is an effective method to correct residual head tilt after IO muscle weakening in patients with SOP. This surgical procedure is believed to decrease head tilt by reducing the vertical deviation and thereby the compensatory head tilt.
Abstract
Purpose: Residual head tilt has been reported in patients with superior oblique muscle palsy (SOP) after surgery to weaken the inferior oblique (IO) muscle. The treatments for these patients have not received appropriate attention. In this study, we evaluated the superior rectus (SR) muscle recession as a surgical treatment. Methods: The medical records of 12 patients with SOP were retrospectively reviewed. Each of these patients had unilateral SR muscle recession for residual head tilt after IO muscle weakening due to SOP. The residual torticollis was classified into three groups on the basis of severity: mild, moderate, or severe. Both IO muscle overaction and vertical deviation, features of SOP, were evaluated in all patients. The severity of the preoperative and postoperative torticollis and vertical deviation were compared using a paired t-test and Fisher’s exact test. Results: The torticollis improved in nine of 12 (75%) patients after SR muscle recession. The difference between the preoperative and postoperative severity of torticollis was statistically significant (p = 0.0008). After surgery, the mean vertical deviation was significantly reduced from 12.4 prism diopters to 1.3 prism diopters (p = 0.0003). Conclusions: Unilateral SR muscle recession is an effective method to correct residual head tilt after IO muscle weakening in patients with SOP. This surgical procedure is believed to decrease head tilt by reducing the vertical deviation and thereby the compensatory head tilt.
참고문헌 (16)
- Helveston EM, "Surgical treatment of superior oblique palsy", Trans Am Ophthalmol Soc, 94, pp.315~328 (1996)
- Simons BD, "Outcome of surgical management of superior oblique palsy: a study of 123 cases", Binocul Vis Strabismus Q, 13, pp.273~282 (1998)
- Toosi SH, "Effect of isolated inferior oblique muscle myectomy in the management of superior oblique muscle palsy", Am J Ophthalmol, 88(3 Pt 2), pp.602~608 (1979)
- Von Noorden GK, "Superior oblique paralysis. A review of 270 cases", Arch Ophthalmol, 104, pp.1771~1776 (1986)
- Davis AR, "Residual symptomatic superior oblique palsy", Strabismus, 15, pp.69~77 (2007)
- Lau FH, "Residual torticollis inpatients after strabismus surgery for congenital superior oblique palsy", Br J Ophthalmol, 93, pp.1616~1619 (2009)
- Madigan WP Jr, "Ocular torsion-direct measurement with indirect ophthalmoscope and protractor", J Pediatr Ophthalmol Strabismus, 29, pp.171~174 (1992)
- Graf M, "Diagnosis and treatment of trochlear nerve palsy", Klin Monbl Augenheilkd, 226, pp.806~811 (2009)
- Knapp P, "First annual Richard G. Scobee memorial lecture. Diagnosis and surgical treatment of hypertropia", Am Orthopt J, 21, pp.29~37 (1971)
- Knapp P, "Diagnosis and surgical options in superior oblique surgery", Int Ophthalmol Clin, 16, pp.137~149 (1976)
- Nishimura JK, "The long-term torsion effect of the adjustable Harada-Ito procedure", J AAPOS, 6, pp.141~144 (2002)
- Ameri A, "Intraoperative adjustable suture surgery for excyclotorsion: a modification of the harada-ito procedure", J Pediatr Ophthalmol Strabismus, 46, pp.368~371 (2009)
- Molinari A, "Frequency of the superior rectus muscle overaction", contracture syndrome in unilateral fourth nerve palsy, 2009, pp.13, 571~574
- contracture syndrome, "Superior rectus overaction", pp.1998, Jampolsky A
- Pacheco EM, "Changes in eyelid position accompanying vertical rectus muscle surgery and prevention of lower lid retraction with adjustable surgery", J Pediatr Ophthalmol Strabismus, 29, pp.265~272 (1992)
- Kushner BJ, "A surgical procedure to minimize lower-eyelid retraction with inferior rectus recession", Arch Ophthalmol, 110, pp.1011~1014 (1992)