Korean J Ophthalmol.  2012 Aug;26(4):285-289. 10.3341/kjo.2012.26.4.285.

Superior Rectus Muscle Recession for Residual Head Tilt after Inferior Oblique Muscle Weakening in Superior Oblique Palsy

Affiliations
  • 1Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 2Department of Ophthalmology, Inje University Paik Hospital, Seoul, Korea.
  • 3Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. ophjun@gmail.com

Abstract

PURPOSE
Residual head tilt has been reported in patients with superior oblique muscle palsy (SOP) after surgery to weaken the inferior oblique (IO) muscle. The treatments for these patients have not received appropriate attention. In this study, we evaluated the superior rectus (SR) muscle recession as a surgical treatment.
METHODS
The medical records of 12 patients with SOP were retrospectively reviewed. Each of these patients had unilateral SR muscle recession for residual head tilt after IO muscle weakening due to SOP. The residual torticollis was classified into three groups on the basis of severity: mild, moderate, or severe. Both IO muscle overaction and vertical deviation, features of SOP, were evaluated in all patients. The severity of the preoperative and postoperative torticollis and vertical deviation were compared using a paired t-test and Fisher's exact test.
RESULTS
The torticollis improved in nine of 12 (75%) patients after SR muscle recession. The difference between the preoperative and postoperative severity of torticollis was statistically significant (p = 0.0008). After surgery, the mean vertical deviation was significantly reduced from 12.4 prism diopters to 1.3 prism diopters (p = 0.0003).
CONCLUSIONS
Unilateral SR muscle recession is an effective method to correct residual head tilt after IO muscle weakening in patients with SOP. This surgical procedure is believed to decrease head tilt by reducing the vertical deviation and thereby the compensatory head tilt.

Keyword

Superior oblique palsy; Superior rectus; Torticollis

MeSH Terms

Adolescent
Adult
Child
Child, Preschool
Diplopia/*surgery
Female
Head Movements
Humans
Infant
Male
Oculomotor Muscles/*surgery
Retrospective Studies
Strabismus/*surgery
Torticollis/*surgery
Treatment Outcome
Trochlear Nerve Diseases/*surgery

Cited by  1 articles

Surgical Management of Superior Oblique Muscle Palsy in Hypertropia 16 Prism Diopters or More
Do Wook Kim, Jinu Han, So Young Han, Sueng-Han Han, Jong Bok Lee
J Korean Ophthalmol Soc. 2016;57(5):823-828.    doi: 10.3341/jkos.2016.57.5.823.


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