基于临床类型制定上斜肌麻痹的个体化治疗方案

上斜肌麻痹是麻痹性斜视和垂直斜视的最常见类型和病因，也是眼性斜颈的代表性疾病，往往需要手术治疗。麻痹性斜视，尤其是垂直旋转肌麻痹，会破坏眼球运动系统的平衡。随着病程的延长，眼球运动系统会自发产生一系列代偿反应，从而建立新的运动平衡，逐渐向共同性扩散，这一系列代偿反应涉及到拮抗肌、配偶肌、协同肌等，使得垂直旋转斜视的临床表现多样，手术治疗方案也因型而异。现结合上斜肌麻痹的国际通用分型，拟就上斜肌麻痹的个性化手术治疗方案的选择、手术要点等进行解析探讨，以期与同道分享交流。

Formulation of individualized treatment plans for superior oblique palsy based on clinical classification and type

Superior oblique palsy （SOP） is a common ocular torticollis disease， and the surgical treatment should be performed early to avoid affecting the patient′s facial and skeletal development. In the clinical development process， SOP can gradually become common strabismus. The clinical classifications of SOP can be divided into congenital and acquired， unilateral and bilateral. According to different clinical manifestations， SOP can further be subdivided into 7 types. Therefore， the surgical treatment for SOP is not only to strengthen the superior oblique muscle， but also to choose the best individualized therapeutic plan to improve the patient's strabismus and head position， based on the clinical development process， classification， and clinical type of SOP.