Yuan N F, Zhou Y Z
Department of Ophthalmology, Fourth Affiliated Hospital, Hebei Medical College, Shijiazhuang.
Zhonghua Yan Ke Za Zhi. 1990 Mar;26(2):83-5.
The authors report 12 cases of isolated inferior oblique muscle paresis which is very uncommon and mostly of congenital origin, though trauma is also cause. The clinical features, differential diagnosis and treatment of the disease are discussed. Inferior oblique palsy is differentiated from contralateral inferior rectus palsy by Park's 3-step test, and from Brown's syndrome by forced duction test and the overaction of the antagonist superior oblique during version. Surgical procedures include shortening and advancement of the inferior oblique muscle, recession of the contralateral superior rectus and shortening of the contralateral inferior rectus muscle, and tenotomy of the ipsilateral superior oblique.
作者报告了12例孤立性下斜肌麻痹病例,这种情况非常罕见,大多为先天性起源,不过外伤也是病因。文中讨论了该疾病的临床特征、鉴别诊断和治疗方法。下斜肌麻痹通过帕克三步试验与对侧下直肌麻痹相鉴别,通过强迫性牵拉试验以及在向对侧注视时下斜肌拮抗肌上斜肌的亢进与布朗综合征相鉴别。手术方法包括下斜肌缩短和前徙术、对侧上直肌后徙术和对侧下直肌缩短术,以及同侧上斜肌断腱术。