SUMMARY We studied 250 patients with consecutive exotropia. The interval between the surgical procedure and the onset of the consecutive exotropia may take many years. Consecutive exotropia occurred with all types of corrective esotropia surgery that we studied. Amblyopia and medial rectus limitation postoperatively seemed to be common factors associated with consecutive exotropia.

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The motor nerve innervation of the extrinsic and intrinsic muscles of the tongue is through the hypoglossal nerve. Hypoglossal nerve palsy arising as a result of injury to the nerve can occur anywhere along its course from the hypoglossal nuclei, medulla oblongata to the tongue itself. Idiopathic isolated and unilateral persistent hypoglossal nerve palsy is an extremely rare condition with only four cases ever reported. In this article, we review reported cases in the literature with comparison to a recent case in the oral and maxillofacial department of University Hospital South Manchester, which highlight the necessity of a segmental and stepwise approach in the diagnosis and management of this condition.

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