Universität zu Köln

Hedergott, Andrea M., Wild, Dana, Fricke, Julia and Neugebauer, Antje (2018). Efficacy of Vertical Muscle Transpositions with and without Simultaneous Rectus Muscle Recession for Unilateral Sixth Nerve Palsy. Klinische Monatsblat. Augenheilkunde, 235 (10). S. 1096 - 1105. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-3999

Full text not available from this repository.

Abstract

Background We report results of a modified vertical muscle transposition procedure according to the Hummelsheim principle - with and without simultaneous rectus muscle recession - for unilateral sixth nerve palsy. We examine the influence of the duration of the palsy, preoperative angle of squint and preoperative abductive capacity on surgical results of the procedures. Patients and Methods Retrospective study of 29 consecutive patients with unilateral abducens nerve palsy who underwent surgery between 2001 and 2012. 21 patients had a modified vertical rectus muscle transposition according to the Hummelsheim principle (HUM); 8 patients had this operation combined with simultaneous medial rectus muscle recession (HUM+I). Surgery was performed at least 9 months after onset of the palsy (HUM: 9 to 98, median 19, mean 30 months; HUM+I: 12 to 65, median 25, mean 29 months). Results The median preoperative angle of squint (far distance) for the HUM group was 27.0 degrees (20.0 to 45.0; mean 28.1 degrees), and for the HUM+I group 30.5 degrees (21.8 to 50.0; mean 33.4 degrees). The median preoperative abductive capacity was for -1,6mm before midline (-8.0 to + 1.2; mean -1.8mm) for the HUM group, and -3.0mm before midline (-10.0 to -1.0; mean -4.1mm) for the HUM+I group. The median postoperative angle of squint (far distance) was 0 degrees (-11.3 to + 20.0; mean 0.1 degrees) for the HUM group, and -2.3 degrees (-11.3 to + 12.0; mean -2.1 degrees) for the HUM+ I group. The median post-operative abductive capacity was 1.0 mm (0 to + 3.0; mean + 1.1 mm) for the HUM group, and 1.1mm (-1.2 to + 3.0; mean + 0.9mm) for the HUM+ I group. The median reduction of squint angle was 27.0 degrees (9.1 to 45.0; mean 28.0 degrees) for the HUM group, and 36.8 degrees (25.2 to 41.4; mean 35.5 degrees) for the HUM+ I group. The median effect on abductive capacity was 2.5 mm (0 to 11.0; mean + 2.9 mm) for the HUM group, and 4.6 mm (2.4 to 8.8; mean + 5.0 mm) for the HUM+ I group. In the HUM group, the effect on squint angle reduced with the duration of the palsy, whereas, in the HUM+ I group, the effect improved with the duration of the palsy. Conclusions For patients with unilateral sixth nerve palsy, simultaneous medial rectus recession increases the effect of modified vertical rectus muscle surgery according to the Hummelsheim principle. The duration of the palsy is a relevant parameter for the selection of a sole or combined intervention with medial rectus recession.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hedergott, Andrea M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wild, Dana UNSPECIFIED UNSPECIFIED UNSPECIFIED Fricke, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Neugebauer, Antje UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-171138
DOI:	10.1055/s-0043-121073
Journal or Publication Title:	Klinische Monatsblat. Augenheilkunde
Volume:	235
Number:	10
Page Range:	S. 1096 - 1105
Date:	2018
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-3999
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ANTERIOR SEGMENT ISCHEMIA; BOTULINUM TOXIN; STRABISMUS SURGERY; HUMMELSHEIM PROCEDURE; ABDUCENS PALSY Multiple languages Ophthalmology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17113