AIM:To describe the experience with half-width vertical muscles transposition(VRT)augmented with posterior fixation sutures.METHODS:The clinical charts of all patients,who underwent half-width VRT augmented with poste...AIM:To describe the experience with half-width vertical muscles transposition(VRT)augmented with posterior fixation sutures.METHODS:The clinical charts of all patients,who underwent half-width VRT augmented with posterior fixation sutures for sixth cranial nerve palsy from January 2003 to December 2018,were retrospectively reviewed.For each patient,pre-and post-operatively,the largest measured angle was used for the calculations,usually resulting with the angle for distance,except in young infants,where measurements were made at near fixation using the Krimsky test.RESULTS:Fifteen patients met the inclusion criteria for the study,of them 9(60.0%)had also medial rectus muscle recession at the time of surgery.Mean follow-up period was 21.4±23.2mo(range 1.5-82mo).Preoperative mean esotropia was 51.3±19.7 prism diopter(PD;range 20-90 PD).Postoperative mean deviation on final follow-up was 7.7±20.2 PD(range-40 to 35 PD;P=0.018).In all patients with preoperative abnormal head position,improvement was noted.Ten(66.7%)patients had improvement in abduction and 10(66.7%)patients reported improvement in their diplopia,by final follow-up.The addition of medial rectus recession was correlated with a larger change in postoperative horizontal deviation compared to baseline(P=0.026).Two(13.3%)patients developed a vertical deviation in the immediate postoperative period which had resolved in one of them.CONCLUSION:Half-width VRT augmented with posterior fixation suture,with or without medial rectus muscle recession,is an effective and safe procedure for esotropia associated with sixth cranial nerve palsy.A major improvement in the angle of deviation is expected.Most patients will have improvement in their abnormal head position and diplopia.展开更多
Background: Acquired See-saw Nystagmus (SSN) is a rare form of nystagmus characterized by elevation and intorsion of one eye with synchronous depression and intorsion of the contralateral eye in the first half cycle, ...Background: Acquired See-saw Nystagmus (SSN) is a rare form of nystagmus characterized by elevation and intorsion of one eye with synchronous depression and intorsion of the contralateral eye in the first half cycle, followed by a reversal in the direction of the movements during the next half cycle. We herein report a case of a 47-year-old woman with a 3-year history of constant diplopia as a consequence of multiple neurosurgical interventions due to hemorrhage from a cavernous angioma located in the subthalamic region. She also had a history of major depressive disorder and ulcerative colitis. The patient underwent a surgical intervention with a 5 mm bilateral recession of the superior and inferior rectus muscles. Five years after surgery, the patient reported less recurrent and prominent episodes of transient horizontal deviation with horizontal diplopia, with a prevalence of well-being and comfort.展开更多
文摘AIM:To describe the experience with half-width vertical muscles transposition(VRT)augmented with posterior fixation sutures.METHODS:The clinical charts of all patients,who underwent half-width VRT augmented with posterior fixation sutures for sixth cranial nerve palsy from January 2003 to December 2018,were retrospectively reviewed.For each patient,pre-and post-operatively,the largest measured angle was used for the calculations,usually resulting with the angle for distance,except in young infants,where measurements were made at near fixation using the Krimsky test.RESULTS:Fifteen patients met the inclusion criteria for the study,of them 9(60.0%)had also medial rectus muscle recession at the time of surgery.Mean follow-up period was 21.4±23.2mo(range 1.5-82mo).Preoperative mean esotropia was 51.3±19.7 prism diopter(PD;range 20-90 PD).Postoperative mean deviation on final follow-up was 7.7±20.2 PD(range-40 to 35 PD;P=0.018).In all patients with preoperative abnormal head position,improvement was noted.Ten(66.7%)patients had improvement in abduction and 10(66.7%)patients reported improvement in their diplopia,by final follow-up.The addition of medial rectus recession was correlated with a larger change in postoperative horizontal deviation compared to baseline(P=0.026).Two(13.3%)patients developed a vertical deviation in the immediate postoperative period which had resolved in one of them.CONCLUSION:Half-width VRT augmented with posterior fixation suture,with or without medial rectus muscle recession,is an effective and safe procedure for esotropia associated with sixth cranial nerve palsy.A major improvement in the angle of deviation is expected.Most patients will have improvement in their abnormal head position and diplopia.
文摘Background: Acquired See-saw Nystagmus (SSN) is a rare form of nystagmus characterized by elevation and intorsion of one eye with synchronous depression and intorsion of the contralateral eye in the first half cycle, followed by a reversal in the direction of the movements during the next half cycle. We herein report a case of a 47-year-old woman with a 3-year history of constant diplopia as a consequence of multiple neurosurgical interventions due to hemorrhage from a cavernous angioma located in the subthalamic region. She also had a history of major depressive disorder and ulcerative colitis. The patient underwent a surgical intervention with a 5 mm bilateral recession of the superior and inferior rectus muscles. Five years after surgery, the patient reported less recurrent and prominent episodes of transient horizontal deviation with horizontal diplopia, with a prevalence of well-being and comfort.
