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Journals / MN Oftalmoloji / 2000 / Cilt: 7 - Sayı: 4

Treatment principles of congenital and acquired third nerve palsy

Doğumsal ve edinsel üçüncü sinir felçlerinde tedavi prensipleri

Huban ATİLLA
Necile ERKAM
Pages
367–371
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

For surgical method, if there is medial rectus function with force generation test, recession-resection can be performed, whereas superior oblique transposition is the preferred method for nonfunctional medial rectus.

📌 3 Key Takeaways

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Objective & Hypothesis:PURPOSE: Evaluation of treatment modalities in patients with congenital and acquired third nerve palsy that has great difficulty among other paralytic strabismus cases.
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Key Findings & Data:RESULTS: Seventeen patients with a mean age of 37.4 years (ranging between 2.5 and 80) were included.
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Conclusion & Impact:For surgical method, if there is medial rectus function with force generation test, recession-resection can be performed, whereas superior oblique transposition is the preferred method for nonfunctional medial rectus.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Göz tembelliği · Geriyedönük çalışma · Şaşılık

Abstract

PURPOSE: Evaluation of treatment modalities in patients with congenital and acquired third nerve palsy that has great difficulty among other paralytic strabismus cases. MATERIALS AND METHODS: Records of patients with congenital and acquired third nerve palsies were examined retrospectively, and the results of treatments were evaluated. RESULTS: Seventeen patients with a mean age of 37.4 years (ranging between 2.5 and 80) were included. Eight out of seventeen had surgical treatment (in partial cases, recession/resection, in cases without medial rectus function additional superior oblique transposition) were performed. Frontalis sling was performed in 3 patients for ptozis. Surgery was not done due to rejection of family or the patient in 5 cases, very low visual acuity (finger couting from 2 meters) in 2 cases and spontaneous recovery in 2 cases. CONCLUSION: In acquired third nerve palsies due to trauma, cerebrovascular accident and neoplasms surgery should be deferred for 6 months for spontaneous recovery however in children surgery should be performed as soon as possible in order to prevent amblyopia. For surgical method, if there is medial rectus function with force generation test, recession-resection can be performed, whereas superior oblique transposition is the preferred method for nonfunctional medial rectus.

Özet

AMAÇ: Paralitik şaşılıklar içinde tedavi büyük güçlük gösteren doğumsal ve edinsel üçüncü sinir felçlerinde tedavi prensiplerinin değerlendirilmesi. GEREÇ VE YÖNTEM: Doğumsal veya edinsel üçüncü sinir felci tanısı almış, takip ve tedavileri yapılmış hastaların dosyalan geriye dönük tarama yöntemi ile incelendi. BULGULAR: Yaşları 2.5 ile 80 arasında değişen (ortalama: 37.4 yıl) 17 hasta çalışma kapsamına alındı. Onyedi hastanın sekizinde cerrahi tedavi (parsiyel olgularda geriletme/rezeksiyon, iç rektus fonksiyonunun olmadığı olgularda ek olarak üst oblik transpozisyonu), 3 hastada ek olarak pitozis için askı yöntemi uygulandı. Beş hastada ailenin veya hastanın isteksizliği, 2 hastada kayan gözde görmenin çok düşük olması (2 mps) ve 2 hastada da spontan düzelmenin olması nedeniyle cerrahi uygulanmadı. SONUÇ: Travma, serebrovasküler atak ve neoplazmlar nedeniyle gelişen erişkin dönem üçüncü sinir felçlerinde en az 6 aylık takip dönemi sonunda cerrahi tedavi planlanırken, doğumsal olgularda, ambliyopinin engellenmesi için en kısa sürede cerrahi tedavi yapılmalıdır. Cerrahi yöntem olarak, kuvvet jenerasyon testi ile iç rektus fonksiyonu olan hastalarda geriletme-rezeksiyon, iç rektus kası fonksiyonu olmayanlarda ise üst oblik transpozisyonu yapılabilir.

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Cite This Article

ATİLLA, H., ERKAM, N. (2000). Treatment principles of congenital and acquired third nerve palsy. MN Oftalmoloji, Cilt: 7 - Sayı: 4, 367–371. https://ajindex.com/articles/296455

References (21)

  1. Balkan R, Hoyt CS. Associated neurologic abnormalities in congenital third nerve palsîes. Am J Ophthalmol 1984; 97:315-9
  2. Mizen TR, Burde RM, Klingele TG. Cryptogenic poulomotor nerve palsies in children. Am J Ophthalmol 1985; 100:65-7
  3. Hamed LM. Associated neurologic and ophthalmologic findings in congenital oculomotor nerve palsy. Ophthalmology 1991; 98:708-14
  4. Trobe JD. Third nerve palsy and the pupil. Footnotes to the rule. Arch Ophthalmol 198S; 106:601-2
  5. Ing EB, Sutlivan TJ, Clarke MP, Buncic JR. Oculomotor nerve palsies in children. J Pediatr Ophthalmol Strabismus 1992; 29:331-6
  6. Daimau BFS. Young boy with progressive double vision. Surv Ophthalmol 199B; 43:47-51
  7. Wolin MJ, Saunders RA. Aneurysmal oculomotor nerve palsy in an 11-year-old boy. J Clin Neuro Ophthalmol 1992; 12:178-80
  8. Abdul-Rahim AS, Savino PJ, Zimmerman RA et al. Cryptogenic oculomotor nerve palsy. The need for repeated neuroimaging studies. Arch Ophthalmol 1989; 107:387-90
  9. Mudgil AV, Repka MX. Ophthalmologic outcome after third cranial nerve palsy or paresis in children. J Pediatr Ophthalmol Strabismus 1999; 3:2-8
  10. Victor Dİ. The diagnosis of congenital unilateral third nerve palsy. Brain1376; 99:711
  11. Tsaloumas MD, Willshaw HE. Congenital oculomotor palsy: Associated neurological and ophthalmological findings. Eye 1997;11:500-3
  12. Miller NR. Solitary oculomotor nerve palsy in childhood. Am J Ophthalmol 1377; 83:106-11
  13. Kerns JM, Smlth DR, Jannotta FS, Alper MG. Oculomotor nerve regeneration after aneurysm surgery. Am J Ophihalmol 1979; 87:225-33
  14. Buckley EG, Townshend LM. A simple transposition procedure for complicated strabismus. Am J Ophthalmol 1991; 111:302-6
  15. Reese PD, Scott WE. Superior oblique tenotomy in the treatment of isolated inferior oblique paresis. J Pediatr Ophthalmol Strabismus 1987; 24:4-9
  16. Noonan CP, O'Connor M. Surgical management of third nerve palsy. Br J Ophthalmol 1995; 79:431-4
  17. Peter LC. The use of superior oblique as an internal rotator in third nerve paralysis. Am J Ophthalmol 1934; 17:297-300
  18. Scott AB. Transposition of the superior oblique muscle. Am OrthoptJ 1977; 27:11-4
  19. Maruo T, lwashige H, Kubota N ve ark. Results of surgery for paralytic exotropia due to oculomotor palsy. Ophthalmologica 1996; 210:163-7
  20. Gottlob I, Catalano RA, Rcinecke RD. Surgİcal management of oculomotor nerve palsy. Am J Ophthalmol 1991; 111:71-6
  21. Wilson ME, Buckley EG, Kivlin JD, Ruttum MS, Simon JW, Ma