Asymmetric superior oblique split Z-tendon lengthening for face turn in bilateral asymmetric superior oblique overaction and exotropia

2020 ◽  
pp. 112067211989798
Author(s):  
Massimiliano Serafino ◽  
Matteo Scaramuzzi ◽  
Claudia Specchia ◽  
Francesco Bonsignore ◽  
Paolo Nucci
Keyword(s):  
Oblique Muscle ◽  
Intermittent Exotropia ◽  
Left Turn ◽  
Vertical Deviation ◽  
Tendon Lengthening ◽  
The Face ◽  
The Right ◽  
Clinical Records ◽  
Superior Oblique Muscle ◽  
Superior Oblique

Introduction: The aim was to evaluate the effectiveness of the procedure of the superior oblique split Z-tendon lengthening to collapse A pattern and treat face turn in a cohort of patients with both incomitant intermittent exotropia and a vertical deviation associated with a bilateral asymmetric superior oblique overaction. Methods: We retrospectively reviewed the clinical records of patients with facial turn associated with intermittent exotropia and bilateral asymmetric superior oblique overaction, who underwent superior oblique muscle split tendon lengthening and concurrent horizontal surgery between 2009 and 2017. Results: A total of eight patients met the inclusion criteria. The preoperative average face turn was 26.8° (range, 20°–5°), and it significantly improved to 5.4° (range, 2°–8°) ( p < 0.05). All the patients showed an improvement in the face turn with neutralization of the vertical deviation. The vertical deviation in the right gaze for the patient with a right turn and the left gaze in patients with left turn improved significantly (values of p < 0.05). Conclusion: The superior oblique split Z-tendon lengthening was an effective procedure to collapse the A pattern and the treatment of the face turn in a cohort of patients with both incomitant intermittent exotropia and a vertical deviation associated with a bilateral asymmetric superior oblique muscle overaction with less complications, and less varying results.

scholarly journals Factors influencing the result of superior oblique weakening procedures in patients with superior oblique overaction in horizontal strabismus

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Junwoo Chun ◽  
Seong-Joon Kim
Keyword(s):  
Success Rate ◽  
University Hospital ◽  
Oblique Muscle ◽  
Vertical Deviation ◽  
Surgical Success ◽  
Significant Difference ◽  
National University ◽  
Dissociated Vertical Deviation ◽  
Superior Oblique Muscle ◽  
Superior Oblique

Abstract Background Few studies have evaluated the surgical outcome of superior oblique weakening procedures in patients with superior oblique overaction associated with exotropia or esotropia. This study aimed to evaluate the outcome of superior oblique muscle weakening and the influencing factors in patients with superior oblique overaction. Methods The medical charts of 37 patients (55 eyes) with superior oblique overaction associated with esotropia or exotropia who were treated with a superior oblique weakening procedure at the Seoul National University Hospital from January 2010 to June 2017 were retrospectively reviewed. Superior oblique overaction was graded using, a 6-point scale ranging from + 0.5 to + 3, and pre- and postoperative grades were recorded for all patients. Results The mean age of the patients was 91.81 ± 59.37 months. Superior oblique muscle suture spacer and superior oblique posterior tenectomy were performed for 17 (23 eyes) and 20 (32 eyes) patients, respectively. Surgical success was achieved in 15 (65.2%) eyes in the suture spacer group and 23 (71.9%) eyes in the posterior tenectomy group. Surgical success was achieved for 69.1% (38/55 eyes) of patients. Dissociated vertical deviation exhibited a significant negative association with the surgical success rate (p < 0.001). Conclusions There was no significant difference in surgical success rate between the superior oblique posterior tenectomy and superior oblique suture spacer groups in superior oblique overaction associated with horizontal strabismus. Associated dissociated vertical deviation can affect the surgical success of the superior oblique weakening procedure.

scholarly journals Factors influencing the result of superior oblique weakening procedures in patients with superior oblique overaction in horizontal strabismus

2020 ◽  
Author(s):  
Junwoo Chun ◽  
Seong-Joon Kim
Keyword(s):  
Success Rate ◽  
University Hospital ◽  
Oblique Muscle ◽  
Vertical Deviation ◽  
Surgical Success ◽  
Significant Difference ◽  
National University ◽  
Dissociated Vertical Deviation ◽  
Superior Oblique Muscle ◽  
Superior Oblique

Abstract Background: Few studies have evaluated the surgical outcome of superior oblique weakening procedures in patients with superior oblique overaction associated with exotropia or esotropia. This study aimed to evaluate the outcome of superior oblique muscle weakening and the influencing factors in patients with superior oblique overaction. Methods: The medical charts of 37 patients (55 eyes) with superior oblique overaction associated with esotropia or exotropia who were treated with a superior oblique weakening procedure at the Seoul National University Hospital from January 2010 to June 2017 were retrospectively reviewed. Superior oblique overaction was graded using, a 6-point scale ranging from +0.5 to +3, and pre- and postoperative grades were recorded for all patients. Results: The mean age of the patients was 91.81 ± 59.37 months. Superior oblique muscle suture spacer and superior oblique posterior tenectomy were performed for 17 (23 eyes) and 20 (32 eyes) patients, respectively. Surgical success was achieved in 15 (65.2%) eyes in the suture spacer group and 23 (71.9%) eyes in the posterior tenectomy group. Surgical success was achieved for 69.1% (38/55 eyes) of patients. Dissociated vertical deviation exhibited a significant negative association with the surgical success rate (p<0.001). Conclusions: There was no significant difference in surgical success rate between the superior oblique posterior tenectomy and superior oblique suture spacer groups in superior oblique overaction associated with horizontal strabismus. Associated dissociated vertical deviation can affect the surgical success of the superior oblique weakening procedure.

scholarly journals The Effects of Modified Graded Recession, Anteriorization and Myectomy of Inferior Oblique Muscles on Superior Oblique Muscle Palsy

2021 ◽  
Vol 10 (19) ◽  
pp. 4433
Author(s):  
Yu-Te Huang ◽  
Jamie Jiin-Yi Chen ◽  
Ming-Yen Wu ◽  
Peng-Tai Tien ◽  
Yung-Ping Tsui ◽  
...  
Keyword(s):  
Torsion Angle ◽  
Head Tilt ◽  
Rectus Muscle ◽  
Clinical Results ◽  
Oblique Muscle ◽  
Torsional Angle ◽  
Ocular Torsion ◽  
Vertical Deviation ◽  
Superior Oblique Muscle ◽  
Superior Oblique

Background: The aim was to investigate the effect of inferior oblique (IO) operation (IO myectomy or graded recession and anteriorization) for unilateral and bilateral superior oblique muscle palsy (SOP); Methods: A total of 167 eyes undergoing IO surgery by a single surgeon between 2008 and 2015 were retrospectively reviewed. The method for treating symmetric bilateral SOP was bilateral IO myectomy (n = 102) and the method for treating unilateral SOP or non-symmetric bilateral SOP was IO-graded recession and anteriorization (n = 65). Associated clinical results and other factors were analyzed; Results: Head tilt, vertical deviation, IO overaction, SO underaction degree and ocular torsion angle were all clearly changed, but there was no statistically significance between these two procedures. Mean preoperative torsional angle was 15.3 ± 6.4 degree, which decreased to 5.3 ± 2.7 degree after surgery. Preoperative torsional angle, IOOA and SOUA degree were all significantly affected in postoperative torsional angle (p = 0.025, 0.003 and 0.038). Horizontal rectus muscle and IO muscle operation did not interfere with each other’s results (p = 0.98); Conclusions: Symmetric bilateral SOP could be treated with bilateral IO myectomy and IO-graded recession and anteriorization should be reserved for unilateral SOP or non-symmetric bilateral SOP.

scholarly journals Factors Influencing the Result of Superior Oblique Weakening Procedures in Patients with Superior Oblique Overaction in Horizontal Strabismus

2020 ◽  
Author(s):  
Junwoo Chun ◽  
Seong-Joon Kim
Keyword(s):  
Success Rate ◽  
University Hospital ◽  
Oblique Muscle ◽  
Vertical Deviation ◽  
Surgical Success ◽  
Significant Difference ◽  
National University ◽  
Dissociated Vertical Deviation ◽  
Superior Oblique Muscle ◽  
Superior Oblique

Abstract Background Few studies have evaluated the surgical outcome of superior oblique weakening procedures in patients with superior oblique overaction associated with exotropia or esotropia. This study aimed to evaluate the outcome of superior oblique muscle weakening and the influencing factors in patients with superior oblique overaction. Methods The medical charts of 37 patients (55 eyes) with superior oblique overaction associated with esotropia or exotropia who were treated with a superior oblique weakening procedure at the Seoul National University Hospital from January 2010 to June 2017 were retrospectively reviewed. Superior oblique overaction was graded using, a 6-point scale ranging from +0.5 to +3, and pre- and postoperative grades were recorded for all patients. Results The mean age of the patients was 91.81 ± 59.37 months. Superior oblique muscle suture spacer and superior oblique posterior tenectomy were performed for 17 (23 eyes) and 20 (32 eyes) patients, respectively. Surgical success was achieved in 15 (65.2%) eyes in the suture spacer group and 23 (71.9%) eyes in the posterior tenectomy group. Surgical success was achieved for 69.1% (38/55 eyes) of patients. Dissociated vertical deviation exhibited a significant negative association with the surgical success rate (p<0.001). Conclusion There was no significant difference in surgical success rate between the superior oblique posterior tenectomy and superior oblique suture spacer groups in superior oblique overaction associated with horizontal strabismus. Associated dissociated vertical deviation can affect the surgical success of the superior oblique weakening procedure.

scholarly journals Factors Influencing the Result of Superior Oblique Weakening Procedures in Patients with Superior Oblique Overaction in Horizontal Strabismus

2020 ◽  
Author(s):  
Junwoo Chun ◽  
Seong-Joon Kim
Keyword(s):  
Success Rate ◽  
University Hospital ◽  
Oblique Muscle ◽  
Vertical Deviation ◽  
Surgical Success ◽  
Significant Difference ◽  
National University ◽  
Dissociated Vertical Deviation ◽  
Superior Oblique Muscle ◽  
Superior Oblique

Abstract Background Few studies have evaluated the surgical outcome of superior oblique weakening procedures in patients with superior oblique overaction associated with exotropia or esotropia. This study aimed to evaluate the outcome of superior oblique muscle weakening and the influencing factors in patients with superior oblique overaction. Methods The medical charts of 37 patients (55 eyes) with superior oblique overaction associated with esotropia or exotropia who were treated with a superior oblique weakening procedure at the Seoul National University Hospital from January 2010 to June 2017 were retrospectively reviewed. Superior oblique overaction was graded using, a 6-point scale ranging from +0.5 to +3, and pre- and postoperative grades were recorded for all patients. Results The mean age of the patients was 91.81 ± 59.37 months. Superior oblique muscle suture spacer and superior oblique posterior tenectomy were performed for 17 (23 eyes) and 20 (32 eyes) patients, respectively. Surgical success was achieved in 15 (65.2%) eyes in the suture spacer group and 23 (71.9%) eyes in the posterior tenectomy group. Surgical success was achieved for 69.1% (38/55 eyes) of patients. Dissociated vertical deviation exhibited a significant negative association with the surgical success rate (p<0.001). Conclusion There was no significant difference in surgical success rate between the superior oblique posterior tenectomy and superior oblique suture spacer groups in superior oblique overaction associated with horizontal strabismus. Associated dissociated vertical deviation can affect the surgical success of the superior oblique weakening procedure.

scholarly journals Isolated pathetick nerve paresis by compression from a dolichoectatic basilar artery: case report

2007 ◽  
Vol 65 (1) ◽  
pp. 176-178 ◽  
Author(s):  
Péricles Maranhão-Filho ◽  
Antonio Aversa Dutra do Souto ◽  
Jânio Nogueira
Keyword(s):  
Case Report ◽  
Magnetic Resonance ◽  
Basilar Artery ◽  
Head Position ◽  
Oblique Muscle ◽  
Ophthalmic Examination ◽  
Nerve Paresis ◽  
The Right ◽  
Superior Oblique Muscle ◽  
Superior Oblique

The article describes a woman with 53 year-old that has presented diplopia when looking down and adopted a tilted head position in order to read for the last six months. The neuro-ophthalmic examination shows isolated right superior oblique muscle paresis. The magnetic resonance and the angioresonance show the dolicoectatic basilar artery compressing the right ventral lateral brainstem.

Intracranial repair of a divided trochlear nerve

1998 ◽  
Vol 88 (2) ◽  
pp. 336-339 ◽  
Author(s):  
Jacobus J. van Overbeeke ◽  
Johannes R. M. Cruysberg ◽  
Tomas Menovsky
Keyword(s):  
Cavernous Sinus ◽  
Tumor Resection ◽  
Posterior Part ◽  
Oblique Muscle ◽  
Trochlear Nerve ◽  
Content Type ◽  
Nerve Fascicle ◽  
The Right ◽  
Superior Oblique Muscle ◽  
Superior Oblique

✓ The authors report the case of a 37-year-old woman in whom the trochlear nerve was transected during removal of a meningioma in the cavernous sinus and subsequently repaired by using microsurgical techniques. This patient presented with a tumor in the posterior part of the right cavernous sinus with expansion over the tentorium. Preoperatively, she suffered from partial deficit of the right trochlear nerve. Intraoperatively, the trochlear nerve was noted to be completely encased by the tumor and was totally divided during removal of the lesion. After tumor resection, the trochlear nerve was repaired by using a sural nerve fascicle secured with sutures and fibrin glue. Six months after the operation, trochlear nerve regeneration became evident as the patient's binocular vision gradually improved. The patient regained normal functioning of the superior oblique muscle 3.5 years after surgery. It is concluded that repair of a divided trochlear nerve is worthwhile and can be followed by successful regeneration and an excellent functional recovery of the superior oblique muscle.

scholarly journals Factors Influencing the Result of Superior Oblique Weakening Procedures in Patients with Superior Oblique Overaction in Horizontal Strabismus

2020 ◽  
Author(s):  
Junwoo Chun ◽  
Seong-Joon Kim
Keyword(s):  
Success Rate ◽  
University Hospital ◽  
Oblique Muscle ◽  
Vertical Deviation ◽  
Surgical Success ◽  
Significant Difference ◽  
National University ◽  
Dissociated Vertical Deviation ◽  
Superior Oblique Muscle ◽  
Superior Oblique

Abstract Background: Few studies have evaluated the surgical outcome of superior oblique weakening procedures in patients with superior oblique overaction associated with exotropia or esotropia. This study aimed to evaluate the outcome of superior oblique muscle weakening and the influencing factors in patients with superior oblique overaction.Methods: The medical charts of 37 patients (55 eyes) with superior oblique overaction associated with esotropia or exotropia who were treated with a superior oblique weakening procedure at the Seoul National University Hospital from January 2010 to June 2017 were retrospectively reviewed. Superior oblique overaction was graded using, a 6-point scale ranging from +0.5 to +3, and pre- and postoperative grades were recorded for all patients. Results: The mean age of the patients was 91.81 ± 59.37 months. Superior oblique muscle suture spacer and superior oblique posterior tenectomy were performed for 17 (23 eyes) and 20 (32 eyes) patients, respectively. Surgical success was achieved in 15 (65.2%) eyes in the suture spacer group and 23 (71.9%) eyes in the posterior tenectomy group. Surgical success was achieved for 69.1% (38/55 eyes) of patients. Dissociated vertical deviation exhibited a significant negative association with the surgical success rate (p<0.001).Conclusions: There was no significant difference in surgical success rate between the superior oblique posterior tenectomy and superior oblique suture spacer groups in superior oblique overaction associated with horizontal strabismus. Associated dissociated vertical deviation can affect the surgical success of the superior oblique weakening procedure.

scholarly journals Isolated Superior Oblique Muscle Swelling Causing Acute Vertical Strabismus in Graves’ Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Keiichi Aomatsu ◽  
Shunji Kusaka
Keyword(s):  
Thyroid Stimulating Hormone ◽  
Oblique Muscle ◽  
Graves Disease ◽  
Related Factors ◽  
Muscle Involvement ◽  
Disease Case ◽  
The Right ◽  
Superior Oblique Muscle ◽  
Superior Oblique ◽  
Stimulating Hormone

Purpose. To report a case of isolated superior oblique muscle swelling causing acute vertical strabismus in Graves’ disease. Case. A 26-year-old woman with a 1-month history of misalignment of the right eye and diplopia was referred to us. Her visual acuity and intraocular pressures were normal in both eyes, but eye movement tests showed clear misalignment of her right eye. Antibody tests for myasthenia gravis were negative. However, blood tests revealed abnormal levels of thyroid-related factors, such as decreased thyroid-stimulating hormone, elevated free T3 and T4, and elevated anti-thyroid-stimulating hormone receptor antibody. We performed magnetic resonance imaging (MRI), which showed slight enlargement of the left superior oblique muscle. The patient was eventually diagnosed with Graves’ disease with superior oblique muscle involvement and underwent a thyroidectomy. Three months postoperatively, her diplopia and abnormal eye movements had substantially resolved. Conclusion. Isolated superior oblique muscle involvement may be a presenting symptom of Graves’ disease. It should be taken into consideration that, in the early stages of thyroid-associated ophthalmopathy (TAO) in adults, only the superior oblique muscle may be enlarged.

scholarly journals Factors Influencing the Result of Superior Oblique Weakening Procedures in Patients with Superior Oblique Overaction in Horizontal Strabismus

2020 ◽  
Author(s):  
Junwoo Chun ◽  
Seong-Joon Kim
Keyword(s):  
Success Rate ◽  
University Hospital ◽  
Oblique Muscle ◽  
Vertical Deviation ◽  
Surgical Success ◽  
Significant Difference ◽  
National University ◽  
Dissociated Vertical Deviation ◽  
Superior Oblique Muscle ◽  
Superior Oblique

Abstract Background: Few studies have evaluated the surgical outcome of superior oblique weakening procedures in patients with superior oblique overaction associated with exotropia or esotropia. This study aimed to evaluate the outcome of superior oblique muscle weakening and the influencing factors in patients with superior oblique overaction.Methods: The medical charts of 37 patients (55 eyes) with superior oblique overaction associated with esotropia or exotropia who were treated with a superior oblique weakening procedure at the Seoul National University Hospital from January 2010 to June 2017 were retrospectively reviewed. Superior oblique overaction was graded using, a 6-point scale ranging from +0.5 to +3, and pre- and postoperative grades were recorded for all patients. Results: The mean age of the patients was 91.81 ± 59.37 months. Superior oblique muscle suture spacer and superior oblique posterior tenectomy were performed for 17 (23 eyes) and 20 (32 eyes) patients, respectively. Surgical success was achieved in 15 (65.2%) eyes in the suture spacer group and 23 (71.9%) eyes in the posterior tenectomy group. Surgical success was achieved for 69.1% (38/55 eyes) of patients. Dissociated vertical deviation exhibited a significant negative association with the surgical success rate (p<0.001).Conclusions: There was no significant difference in surgical success rate between the superior oblique posterior tenectomy and superior oblique suture spacer groups in superior oblique overaction associated with horizontal strabismus. Associated dissociated vertical deviation can affect the surgical success of the superior oblique weakening procedure.

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