University College London Medical School, United Kingdom; Royal Free Hospital London, United Kingdom; Luton & Dunstable Hospital, United Kingdom.
Royal Free Hospital London, United Kingdom.
J AAPOS. 2021 Feb;25(1):18.e1-18.e5. doi: 10.1016/j.jaapos.2020.10.008. Epub 2021 Feb 16.
To compare the effectiveness of inferior oblique myectomy and anterior transposition for correction of hypertropia in trochlear nerve palsy.
This retrospective study compares the surgical outcome of 40 patients with hypertropia secondary to trochlear nerve palsy who underwent either a unilateral myectomy or anterior transposition of the inferior oblique muscle. The primary outcome measure was the change in vertical deviation in primary gaze.
A total of 40 patients with a mean age of 41 years were included. There was no statistically significant difference between groups (near preoperative hypertropia, P = 0.134 [Mann-Whitney test]). Of these, 19 underwent anterior transpositions and 21 myectomies. Both surgical techniques were successful at reducing levels of vertical deviation (anterior transposition, 89%; myectomy, 76%). However, the relative percentage reduction showed a statistically significant difference in postoperative outcomes, with anteriorization being more effective (anteriorization, 82%; myectomy 48%; P = 0.003).
In this study cohort, anterior transposition was more effective than myectomy at correcting vertical deviation in patients with inferior oblique overaction secondary to trochlear nerve palsy.
比较下斜肌切除术和下斜肌前徙术治疗滑车神经麻痹性斜视的疗效。
本回顾性研究比较了 40 例因滑车神经麻痹而导致斜视的患者接受单侧下斜肌切除术或下斜肌前徙术的手术效果。主要观察指标为第一眼注视时垂直偏斜的变化。
共纳入 40 例平均年龄为 41 岁的患者。两组间无统计学差异（近术前斜视，P=0.134[Mann-Whitney 检验]）。其中 19 例行前徙术，21 例行肌切除术。两种手术技术均能有效降低垂直偏斜度（前徙术 89%；肌切除术 76%）。然而，术后结果的相对百分比降低显示出统计学上的显著差异，前徙术更有效（前徙术 82%；肌切除术 48%；P=0.003）。
在本研究队列中，与下斜肌切除术相比，前徙术在治疗滑车神经麻痹性斜视伴下斜肌亢进引起的垂直斜视方面更有效。
