先天性上斜肌麻痹手术治疗的年龄探讨

目的:探讨先天性上斜肌麻痹的早期手术治疗年龄。方法:回顾性总结我科7mo～7岁21例先天性上斜肌麻痹患者接受下斜肌部分切除术的手术效果。结果:本组7mo～7岁21例患儿垂直斜视及伴水平斜视和V型斜视术后均获矫正,20例代偿头位完全改善,1例部分改善,术后1wk内头位完全矫正率2岁以下为91%(10/11),2岁以上40%(4/10)。21例Bielschowsky歪头试验全部阴性,无1例并发症发生。结论:先天性上斜肌麻痹一经确诊,应及时手术。1岁内患儿有代偿头位,垂直斜视,且Bielschowsky歪头试验阳性,全身状况良好者,可即行手术矫正。

On the age of operative therapy of congenital superior oblique palsy

AIM:To investigate the age for an appropriate earlier operation time on congenital superior oblique palsy.METHODS:The effects of operation were retrospectively analyzed in twenty-one cases of congenital superior oblique palsy(7 months-7 years old) undergone in our department part-excision of the inferior oblique muscle.RESULTS:After the operation,vertical strabismus,level strabismus and V-type strabismus were correct in all of the 21 cases,and compensative head station seen before the surgery disappeared completely in 20 cases,and partly disappeared in only one case.One week after the operation,head correction rate was 91%(10/11) for children below 2 years old and 40%(4/10) for those over 2 years of age.Bielschowsky test turned negative in all cases and no complications occurred.CONCLUSION:Congenital superior oblique palsy needs surgery as soon as being diagnosed.Children with compensative head station,vertical strabismus and positive result of Bielschowsky test should undergo operation if the whole body conditions are good.