Rao R, Morton G V, Kushner B J
Pediatric Eye and Adult Strabismus Clinic, Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, USA.
Binocul Vis Strabismus Q. 1999;14(1):27-32.
Ocular torticollis secondary to congenital superior oblique palsy can be associated with facial asymmetry. The purpose of this study was to determine if other ocular causes of head tilting also carry the same association.
The study design was clinical evaluation of patients.
Fifteen patients with marked, moderate, or mild head tilts associated with dissociated vertical deviation (DVD), and 3 patients with nystagmus and a torsional null point. A control group was comprised of 3 patients with congenital superior oblique palsy, 3 with traumatic superior oblique palsy, and two normal patients.
A masked observer analyzed full-face photographs of the subjects.
The presence of facial asymmetry.
Facial asymmetry due to bending in/of the sagittal plane of at least two degrees was found in 3 of 4 patients with a marked head tilt from DVD, in 2 of 5 five patients with a moderate head tilt from DVD, in one of 3 patients with a head tilt due to nystagmus, and in one of 3 patients with a head tilt due to congenital superior oblique palsy. None of the patients with a mild head tilt from DVD, traumatic superior oblique palsy, or the normal controls had clinically noticeable facial asymmetry.
Facial asymmetry can be associated with abnormal head postures, specifically, large head tilts from DVD or nystagmus.
先天性上斜肌麻痹继发的眼性斜颈可能与面部不对称有关。本研究的目的是确定其他导致头部倾斜的眼部原因是否也存在同样的关联。
本研究设计为对患者进行临床评估。
15例伴有分离性垂直偏斜（DVD）的明显、中度或轻度头部倾斜患者，以及3例伴有眼球震颤和扭转零点的患者。对照组由3例先天性上斜肌麻痹患者、3例外伤性上斜肌麻痹患者和2例正常患者组成。
一名蒙面观察者分析受试者的全脸照片。
面部不对称的存在情况。
在4例因DVD导致明显头部倾斜的患者中，有3例存在矢状面至少弯曲2度的面部不对称；在5例因DVD导致中度头部倾斜的患者中，有2例存在面部不对称；在3例因眼球震颤导致头部倾斜的患者中，有1例存在面部不对称；在3例因先天性上斜肌麻痹导致头部倾斜的患者中，有1例存在面部不对称。在因DVD导致轻度头部倾斜的患者、外伤性上斜肌麻痹患者或正常对照组中，均未发现临床上明显的面部不对称。
面部不对称可能与异常的头部姿势有关，具体而言，与因DVD或眼球震颤导致的大幅度头部倾斜有关。
