scholarly journals Treatment of acute acquired concomitant esotropia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Minghua Shi ◽  
Yuanxiang Zhou ◽  
Aijiao Qin ◽  
Jing Cheng ◽  
Hongxing Ren

Abstract Background The treatment efficacy of botulinum toxin bilateral medial rectus injections for acute acquired concomitant esotropia (AACE) in adult is not clear. We characterize the effects of botulinum toxin injection in the treatment of AACE, especially in patients over 14 years old, and compared it with surgical treatment. Methods In this prospective, nonrandomized, controlled clinical study, patients with AACE in our hospital from March 2017 to March 2020 elected to receive bilateral medial rectus injections of botulinum toxin or to undergo extraocular muscle surgery. Ocular position and stereopsis were evaluated before and after treatment. Results A total of 60 patients were treated: 40 patients in the botulinum toxin group, and 20 patients in the surgery group. The botulinum toxin group included 31 cases ≥ 14 years of age and 9 cases < 14 years of age. After 1–3 botulinum injections, the cumulative initial success rate was 95% (38/40), and the recurrence rate was 22.5% (9/40). Nine children < 14 years of age were treated successfully, without recurrence. In the surgery group, the initial success rate after surgery was 75% (17/20), and the recurrence rate was 20% (4/20). There was no significant difference between groups in the rate of success rate or the rate of recurrence (P > 0.05). Conclusion The injection of botulinum toxin has a good effect on AACE in adults and children. The outcomes achieved with injected botulinum toxin are similar to those achieved with surgery. Trial registration ChiCTR, ChiCTR2000032544. Registered May 2, 2020, Retrospectively registered.

2020 ◽  
Author(s):  
Minghua Shi ◽  
Yuanxiang Zhou ◽  
Aijiao Qin ◽  
Jing Chen ◽  
Hongxing Ren

Abstract Background: The treatment efficacy of botulinum toxin bilateral medial rectus injections for acute acquired concomitant esotropia (AACE) in adult is not clear. We characterize the effects of botulinum toxin injection in the treatment of AACE, especially in patients over 14 years old,and compared it with surgical treatment.Methods: In this prospective, nonrandomized, controlled clinical study, patients with AACE in our hospital from March 2017 to March 2020 elected to receive bilateral medial rectus injections of botulinum toxin or to undergo extraocular muscle surgery. Ocular position and stereopsis were evaluated before and after treatment.Results: A total of 60 patients were treated: 40 patients in the botulinum toxin group, and 20 patients in the surgery group. The botulinum toxin group included 31 cases ≥14 years of age and 9 cases <14 years of age. After 1–3 botulinum injections, the cumulative initial success rate was 95% (38/40), and the recurrence rate was 22.5% (9/40). Nine children <14 years of age were treated successfully, without recurrence. In the surgery group, the initial success rate after surgery was 75% (17/20), and the recurrence rate was 20% (4/20). There was no significant difference between groups in the rate of success rate or the rate of recurrence (P>0.05).Conclusion: The injection of botulinum toxin has a good effect on AACE in adults with minimal squinting and in children. The outcomes achieved with injected botulinum toxin are similar to those achieved with surgery.Trial registration: ChiCTR, ChiCTR2000032544. Registered May 2, 2020,Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=52349


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Li-juan Lang ◽  
Yu Zhu ◽  
Zhi-gang Li ◽  
Guang-ying Zheng ◽  
Hai-ying Peng ◽  
...  

Abstract We compared the therapeutic effects between botulinum toxin and surgery for acute acquired comitant esotropia (AACE) and analyze its clinical characteristics. The data of the 29 cases, who received treatment for AACE in the Ophthalmic Center of the First Affiliated Hospital of Zhengzhou University and Henan Provincial Ophthalmology Hospital between January 2016 and January 2017, were collected. The 29 cases with AACE were followed for 6 months or more, and received either botulinum toxin injection (group A with 13 cases) or squint correction (group B with 16 cases). The distant and near deviation angles were compared between the two groups before and after treatment. The success rate (total horizontal deviation of 10 prism diopters or less) and stereopsis were compared between the two groups at post-treatment 6 months. At the same time, the relations between distant and near deviation angles were analyzed among different myopia levels and different AACE types. Results indicated that he success rate was not significantly different at post-treatment 6 months (84.6% vs 81.3%, P = 1.00). The distant and near deviation angles were all significantly different one day and one month after treatment (all P < 0.05); but at post-treatment 6 months, they were not significantly different (all P > 0.05) between the two groups. There were no significant differences in the distant and near stereoacuity between the two groups at post-treatment 6 months (all P > 0.05). Among the 25 cases with myopia, the pre-treatment distant deviation angle was significantly higher than pre-treatment near deviation angle in the cases with myopia level >−2.5 D (P < 0.05), and the pre-treatment distant and near deviation angles were all significantly higher in the cases with type-IIAACE than in the cases with type-IIIAACE (all P < 0.05). This study suggests that Botulinum toxin is as effective as surgery in the treatment of AACE at post-treatment 6 months. For the cases with myopia level >−2.5 D, the pre-treatment distant deviation angle is significantly higher than pre-treatment near deviation angle; and both pre-treatment distant and near deviation angles are greater in the cases with type-IIAACE than in the cases with type-IIIAACE.


2011 ◽  
Vol 6 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Erkan Vuralkan ◽  
Cem Saka ◽  
Istemihan Akin ◽  
Sema Hucumenoglu ◽  
Binnur Uzmez Unal ◽  
...  

Background: The aim of our study was to compare the effects of montelukast and mometasone furoate nasal spray on the postoperative course of patients with nasal polyposis. Patients and methods: Fifty patients diagnosed with nasal polyposis between March 2006 and August 2007 were included in the study. All patients underwent bilateral endoscopic sphenoethmoidectomy and were randomized postoperatively into two groups. Group A ( n = 25) received 10 mg montelukast per day and group B ( n = 25) received 400 µg mometasone furoate nasal spray twice daily. All patients were followed up for 6 months. Sino-Nasal Outcome Test (SNOT)-22 scores, polyp grades, computerized tomography (CT) scores (Lund–Mackay), eosinophils in peripheral blood and polyp tissue were evaluated before and after surgery. Results: There was a significant reduction in SNOT-22 scores in both groups throughout the study period. There was a significant difference in the recurrence rate between both groups with a marginal advantage of mometasone furoate nasal spray. Eosinophils in peripheral blood were found to be effective on the recurrence rate ( p < 0.05). Conclusions: In conclusion, both drugs seem to have a complementary action and further studies are needed to determine which patients should receive which treatment.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hongjia Xu ◽  
Weifeng Sun ◽  
Shuying Dai ◽  
Yanyan Cheng ◽  
Jing Zhao ◽  
...  

Purpose. To report on an improved botulinum toxin injection with conjunctival microincision for beginners, and to determine the effectiveness of botulinum toxin A (BTXA) in the treatment of patients with acute acquired comitant esotropia (AACE). Methods. Medical records of 29 AACE patients were retrospectively analyzed. BTXA was injected into the unilateral or bilateral medial rectus muscle with conjunctival microincision without electromyographic guidance. Success was defined as total horizontal deviation ≤10 prism diopters (PD) and evidence of binocular vision. Results. Twenty-nine patients were included, of whom 22 were male and 7 were female. The mean age at onset was 14.2 ± 7.4 (range, 4–34) years. The mean time from onset of AACE to injection was 18.4 ± 20.3 (range, 1–96) weeks. All patients completed at least 6 months of follow-up, and the mean follow-up after BTXA injection was 12.3 ± 4.8 months (range, 7–24 months). Neurological evaluation and brain magnetic resonance imaging (MRI) were unremarkable in all patients. The mean spherical equivalent refraction was −1.22 ± 2.85D and −0.97 ± 2.80D in the right and left eyes, respectively. Mean preinjective esotropia was 38.4 ± 18.9 PD (range, +10–+80 PD) at near and 40.2 ± 17.7 PD (range, +20–+80 PD) at far distance. The mean angle of deviation at 6 months after injection was 0.6 ± 4.1 PD (range, −3–+15 PD) at near and 3.0 ± 5.9 PD (range, 0–+20 PD) at far distance. There was significant difference in the angle of deviation at near and far fixation between pre-BTXA and post-BTXA 6 months ( p < 0.001 , p < 0.001 , resp.). There was no significant difference in the angle of deviation at near and far fixation between post-BTXA 6 months and post-BTXA at final follow-up ( p  = 0.259 and 0.326, resp.). Mean stereoacuity improved from 338 to 88 arc seconds. During the follow-up period, 5 of 29 patients had recurrent esotropia. Two patients refused all further treatment, and the other 3 patients required incisional strabismus surgery. The success rates were 86.2% (25/29) at 6 months and 82.8% (24/29) at final follow-up. Conclusion. Conjunctival microincision injection of botulinum toxin is a practical and safe method for beginners to locate an extraocular muscle, which is as effective as the traditional methods. Botulinum toxin injection can be preferred as the first-line treatment for AACE patients with potential binocular vision.


2008 ◽  
Vol 246 (9) ◽  
pp. 1307-1314 ◽  
Author(s):  
Guillaume Casse ◽  
Jean-Paul Adenis ◽  
Jean-Pierre Sauvage ◽  
Pierre-Yves Robert

2021 ◽  
Vol 7 (5) ◽  
pp. 3374-3378
Author(s):  
Haiyan Cheng ◽  
Yanjie Song ◽  
Wenhua Zhang ◽  
Juanzhi Hao

Objective: The effect of mifepristone and GnRH-a on patients with endometriosis after operation. Methods: 100 cases of endometriosis treated by laparoscopic surgery in our hospital from May 2017 to October 2019 were divided into GnRH-a group (34 cases), mifepristone group (33 cases) and non-drug group (33 cases) according to the numerical random method, and the treatment effect of the three groups was compared. Result: After the drug treatment, the cumulative recurrence rate of non misoprostone group and GnRH-a group was 18.18% and 21.21%, P > 0.05 between the two groups, and 33.33% between the two groups, P < 0.05. After treatment, FSH, LH and other hormone indexes in mifepristone group were compared with those before treatment (P > 0.05), while E2 levels were compared with those before treatment (P < 0.05); FSH, LH, E2 levels in GnRH-a group were compared with those before treatment (P < 0.05), and those in mifepristone group were compared with those after treatment (P < 0.05). After treatment, the complete remission rate of the patients in the non misoprostone group and the GnRH-a group were 51.52% and 55.88%, respectively, P > 0.05 for the comparison between the groups, and 36.36% for the comparison between the patients in the non misoprostone group and the GnRH-a group, P < 0.05 for the comparison between the two groups. There was no significant difference between the two groups (P > 0.05). Conclusion: Mifepristone and GnRH-a have good effect on patients with endometriosis after operation. They can effectively reduce the recurrence rate and adverse reactions after EMT.


2017 ◽  
Vol 13 (4) ◽  
pp. 323-327 ◽  
Author(s):  
S.S. Chhetri ◽  
R. Gautam

Background Voice problems caused by pathologies in vocal folds are well known. Some types of laryngeal pathologies have certain acoustic characteristics. Objective evaluation helps characterize the voice and voice problems providing supporting evidences, severity of disorders. It helps assess the response to the treatment and measures the outcomes.Objective The objective of the study is to determine the effectiveness of the voice therapy and quantify the results objectively by voice parameters.Method Study includes 61 patients who presented with different types of laryngeal pathologies. Acoustic analyses and voice assessment was done with Dr. Speech ver 4 (Tiger DRS Inc.). Acoustic parameters including fundamental frequency, jitters, shimmers, Harmonic to noise ratio (HNR), Normalized noise energy (NNE) were analyzed before and after voice therapy.Result Bilateral vocal nodules were the most common pathologies comprising 44.26%. All acoustic parameters showed a significant difference after the therapy (p<0.05) except for NNE. Dysphonia due to vocal fold polyp showed no improvement even after voice therapy (p>0.05).Conclusion Acoustic analysis provides an objective, recordable data regarding the voice parameters and its pathologies. Though, few pathology require alternative therapy rather than voice therapy, overall it has a good effect on glottic closure. As the voice therapy can improve the different indices of voice, it can be viewed as imperative part of treatment and to monitor progression.


2011 ◽  
Vol 43 (5) ◽  
pp. 420-423 ◽  
Author(s):  
G Santus ◽  
S Faletti ◽  
I Bordanzi ◽  
F Pirali ◽  
D De Grandis

2019 ◽  
Vol 98 (6) ◽  
pp. 351-355 ◽  
Author(s):  
Stephen R. Chorney ◽  
Jennifer A. Villwock ◽  
Amar C. Suryadevara

Botulinum toxin is the most commonly performed facial cosmetic procedure and pain at the injection site is a frequent patient concern. While various topical interventions have been described for analgesia, there have not been any studies comparing different techniques. We compared the use of a vibratory stimulus, ice pack application, and no intervention on injection site pain for cosmetic botulinum toxin injection. A prospective-, randomized-, individual-controlled study was conducted using a visual analog scale to assess pain. Patients received bilateral glabellar injections, with randomization into unilateral vibration, unilateral ice application, or vibration and ice on either side. We analyzed 88 injections on 22 patients. Mean visual analog scores were 26.5 (standard deviation [SD]: 23.1) among injections with vibration, 24.4 (SD: 22.9) with ice, and 29.4 (SD: 27.1) without analgesia. There was no significant difference in pain scale scores with the use of vibration, ice, or no topical anesthesia ( P = .737). Further, pain scale scores did not differ significantly between medial and lateral injections nor did patients have a reduction in pain on either side of the forehead regardless of which method was used. While there may be a role for topical interventions to improve injection site analgesia, we maintain that consistently proper technique plays a greater role in improving patient tolerance. Future studies will continue to investigate the role of topical anesthesia in cosmetic facial injections and address patient-specific factors contributing to discomfort.


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