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  • Title: [Surgical treatment of torticollis in cases of congenital nystagmus with strabismus].
    Author: Ohtsuki H, Konishi H, Fujiwara Y, Hasebe S, Tadokoro Y.
    Journal: Nippon Ganka Gakkai Zasshi; 1989 Aug; 93(8):836-43. PubMed ID: 2610164.
    Abstract:
    To correct compensatory head turn in twelve cases with congenital nystagmus, they were classified into two types according to the relative visual lines of both eyes to each other with respect to the sagittal axis of the head or the median plane of the body. One was termed the symmetrical pattern and the other was termed the asymmetrical pattern. In cases of the symmetrical pattern, a neutral zone exists in which the dominant eye in in the adducted position of gaze with esotropia and in the abducted position of gaze with exotropia. However, in the case of the asymmetrical pattern the neutral zone of the dominant eye is located in the abducted position of gaze with esotropia and in the abducted position of gaze with exotropia. Surgery was performed by shifting the dominant eye to the direction of the sagittal axis of the head in accordance with the degree of ocular deviation in the primary position. In asymmetrical pattern cares, both eyes were surgically shifted in parallel to the direction of the sagittal axis of the head without regard to the types of strabismus. The operation was based on the degree of compensatory head turn. We compared the surgical results the two types. In symmetrical cases, decreasing strabismus was disappointing compared to the head turn, while in asymmetrical cases decreasing head turn was disappointing as compared to strabismus. From these results surgery should be confined to the dominant eye in symmetrical cases, taking as the basis for operation the degree of head turn and not the ocular deviation.(ABSTRACT TRUNCATED AT 250 WORDS)
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