Surgical Outcomes of Inferior Oblique Myectomy in Unilateral Congenital Superior Oblique Palsy with or without Trochlear Nerve.
To compare the surgical outcomes of inferior oblique (IO) myectomy in congenital superior oblique palsy (SOP) according to the presence of the trochlear nerve identified with high-resolution MRI.Forty-one congenital SOP patients without a trochlear nerve (absent group) and 23 patients with a trochle...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2016-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4938404?pdf=render |
| _version_ | 1818511174677823488 |
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| author | Ji Eun Lee Hee Kyung Yang Jeong-Min Hwang |
| author_facet | Ji Eun Lee Hee Kyung Yang Jeong-Min Hwang |
| author_sort | Ji Eun Lee |
| collection | DOAJ |
| description | To compare the surgical outcomes of inferior oblique (IO) myectomy in congenital superior oblique palsy (SOP) according to the presence of the trochlear nerve identified with high-resolution MRI.Forty-one congenital SOP patients without a trochlear nerve (absent group) and 23 patients with a trochlear nerve (present group) who underwent IO myectomy as the primary surgical treatment were retrospectively reviewed. "Motor success" was defined as postoperative ipsilateral hypertropia ≤ 4 prism diopter (PD). "Head tilt improvement" was regarded as postoperative angle of head tilt < 5 degrees (°). Success rates for motor alignment and head tilt improvement, cumulative probabilities of success, and factors influencing surgical responses were evaluated.The cumulative probabilities of motor success at 2 years after IO myectomy were 92% in patients with a trochlear nerve and 86% in patients without a trochlear nerve (P = 0.138). The cumulative probabilities of undercorrection and recurrence of hypertropia after 2 years were 0% in the present group versus 21% in the absent group (P = 0.014). The cumulative probabilities of persistent head tilt after 2 years were 14% in the present group and 20% in the absent group (P = 0.486). A younger age at operation was associated with reduced probabilities of motor success and head tilt improvement (P = 0.009, P = 0.022 respectively). A greater preoperative angle of head tilt was associated with persistent head tilt after surgery (P = 0.038).Congenital SOP without a trochlear nerve had a higher risk of hypertropia undercorrection after IO myectomy compared to patients with a trochlear nerve. A younger age at operation and larger preoperative head tilt was related to poor outcomes. |
| first_indexed | 2024-12-10T23:29:51Z |
| format | Article |
| id | doaj.art-8a6a03a8ad3b486a9ed4a34602fa374f |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T23:29:51Z |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-8a6a03a8ad3b486a9ed4a34602fa374f2022-12-22T01:29:26ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01117e015687210.1371/journal.pone.0156872Surgical Outcomes of Inferior Oblique Myectomy in Unilateral Congenital Superior Oblique Palsy with or without Trochlear Nerve.Ji Eun LeeHee Kyung YangJeong-Min HwangTo compare the surgical outcomes of inferior oblique (IO) myectomy in congenital superior oblique palsy (SOP) according to the presence of the trochlear nerve identified with high-resolution MRI.Forty-one congenital SOP patients without a trochlear nerve (absent group) and 23 patients with a trochlear nerve (present group) who underwent IO myectomy as the primary surgical treatment were retrospectively reviewed. "Motor success" was defined as postoperative ipsilateral hypertropia ≤ 4 prism diopter (PD). "Head tilt improvement" was regarded as postoperative angle of head tilt < 5 degrees (°). Success rates for motor alignment and head tilt improvement, cumulative probabilities of success, and factors influencing surgical responses were evaluated.The cumulative probabilities of motor success at 2 years after IO myectomy were 92% in patients with a trochlear nerve and 86% in patients without a trochlear nerve (P = 0.138). The cumulative probabilities of undercorrection and recurrence of hypertropia after 2 years were 0% in the present group versus 21% in the absent group (P = 0.014). The cumulative probabilities of persistent head tilt after 2 years were 14% in the present group and 20% in the absent group (P = 0.486). A younger age at operation was associated with reduced probabilities of motor success and head tilt improvement (P = 0.009, P = 0.022 respectively). A greater preoperative angle of head tilt was associated with persistent head tilt after surgery (P = 0.038).Congenital SOP without a trochlear nerve had a higher risk of hypertropia undercorrection after IO myectomy compared to patients with a trochlear nerve. A younger age at operation and larger preoperative head tilt was related to poor outcomes.http://europepmc.org/articles/PMC4938404?pdf=render |
| spellingShingle | Ji Eun Lee Hee Kyung Yang Jeong-Min Hwang Surgical Outcomes of Inferior Oblique Myectomy in Unilateral Congenital Superior Oblique Palsy with or without Trochlear Nerve. PLoS ONE |
| title | Surgical Outcomes of Inferior Oblique Myectomy in Unilateral Congenital Superior Oblique Palsy with or without Trochlear Nerve. |
| title_full | Surgical Outcomes of Inferior Oblique Myectomy in Unilateral Congenital Superior Oblique Palsy with or without Trochlear Nerve. |
| title_fullStr | Surgical Outcomes of Inferior Oblique Myectomy in Unilateral Congenital Superior Oblique Palsy with or without Trochlear Nerve. |
| title_full_unstemmed | Surgical Outcomes of Inferior Oblique Myectomy in Unilateral Congenital Superior Oblique Palsy with or without Trochlear Nerve. |
| title_short | Surgical Outcomes of Inferior Oblique Myectomy in Unilateral Congenital Superior Oblique Palsy with or without Trochlear Nerve. |
| title_sort | surgical outcomes of inferior oblique myectomy in unilateral congenital superior oblique palsy with or without trochlear nerve |
| url | http://europepmc.org/articles/PMC4938404?pdf=render |
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