Partial third cranial nerve palsy: clinical characteristics and surgical management

Flanders, Michael; Hasan, Jesia; Al‐Mujaini, Abdullah

doi:10.1016/j.jcjo.2012.03.030

Cited by 19 publications

(13 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At the end of follow-up, an ocular deviation of less than 10 pd was obtained in 64.5% of cases, diplopia in PP resolved in 72.2% of cases, and torticollis resolved in 35.2%. These findings are similar to those reported in other publications,6, 7, 13, 21 which can reach 90% with combined procedures 17 . In any case, regardless of the type of surgery, favorable esthetic results can only be obtained in PP, as eye rotations cannot be completely re-established 3 .…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Long term outcomes of strabismus surgery for third nerve palsy

Merino

Gutierrez

Liaño

et al. 2019

Journal of Optometry

View full text Add to dashboard Cite

Purpose To report long-term outcomes of strabismus surgery for treatment of third nerve palsy. Methods We performed a 15-year retrospective study of patients who had undergone surgery. We analyzed preoperative mean deviation (at 6 months, 1 year after surgery, and at the end of follow-up), type of surgery, and factors predicting outcomes. A final deviation <10 prism diopters (pd) was considered a good esthetic outcome, and no diplopia in the primary position at the end of follow-up was considered a good functional outcome. Results Surgery was performed in 31 cases. Mean age was 36.27 years (women, 51.6%). Total and complete third nerve palsy was recorded in 22.6% and acquired palsy in 80.6%. Mean preoperative horizontal deviation (HD) in primary position was 40.24 pd (near) and 44.29 (distance) and 14.33 pd in vertical deviation (VD). Mean final HD was 8.94 pd (near) and 11.35 pd (distance), and mean final VD was 6.13. One surgery was performed in 68.9%. A favorable esthetic outcome was obtained in 64.5% and a successful functional outcome in 72.2%. Statistically significant differences were found between near HD ( p = 0.019) and distance HD ( p = 0.035) at 1 year compared with the end of follow-up and between VD at 6 months and 1 year after surgery ( p = 0.03). Mean follow-up was 6.05 years. No specific factors predicted a successful outcome. Conclusions Esthetic and functional results were similar. No predictors of successful outcome were identified. HD was better 1 year after surgery, and VD improved during follow-up.

show abstract

Section: Discussionsupporting

confidence: 91%

“…Third nerve palsies can be complete or incomplete, total or partial, and congenital or acquired 5, 6. In complete palsy, the eye is in exotropia, hypotropia, and cyclotorsion, with limitation of adduction, elevation, and depression.…”

Section: Introductionmentioning

confidence: 99%

Long term outcomes of strabismus surgery for third nerve palsy

Merino

Gutierrez

Liaño

et al. 2019

Journal of Optometry

View full text Add to dashboard Cite

show abstract

“…11,13 There were limited cases in the literature for surgical correction of isolated oculomotor nerve palsy. [14][15][16] Flanders and colleagues presented a case series comprising 12 adult patients whose chief complaint of diplopia. 16 But all of these cases had underlying etiologic reasons such as an aneurysm, tumor, and SVO.…”

Section: Discussionmentioning

confidence: 99%

Management of a Case with Isolated Oculomotor Nerve Palsy

Gök¹,

Aslan²,

Altıntaş³

2019

Turkiye Klinikleri J Ophthalmol

View full text Add to dashboard Cite

he oculomotor nerve is divided into superior and inferior divisions in the region of the anterior cavernous sinus and superior orbital fissure. The superior division oculomotor palsy is usually seen in spheno-cavernous region or orbital apex. Oculomotor superior division innervates levator palpebrae superioris and superior rectus muscles. Therefore, mild ptosis and upgaze restriction could be seen in patients with superior division palsy, besides pupillary reactions have been preserved. 1 1 1 Management of a Case With IsolatedOculomotor Nerve Palsy A AB BS ST TR RA AC CT T The oculomotor nerve has a divisional topographic arrangement at the brain stem and extends with fascicular, cisternal, cavernous sinus and orbital portions. The lesions, at any site along this course, can cause nerve paralysis and the etiologies may differ in adult and child age groups. Congenital reasons, craniopharyngioma, trauma, inflammatory and infectious causes, ophthalmoplegic migraine, malignancy (lymphoma, leukemia), cranial aneurysms are the possible underlying diagnoses in the childhood. The most of the divisional oculomotor nerve palsy reports in the literature are linked to post-viral etiology in the child age group. The current clinical picture resolved spontaneously in these cases. We presented a case of an 8-year-old girl with left eye superior division oculomotor palsy. The clinical investigations for clarifying underlying causes were unremarkable. After a certain follow-up period for spontaneous resolution, surgical treatment was performed and this case is the first one who treated successfully with surgery in the child age group.K Ke ey yw wo or rd ds s: : Oculomotor nerve; child; surgery Ö ÖZ ZE ET T Okülomotor sinir, beyin sapında topografik olarak fasiküler, sisternal, kavernöz sinüs ve orbital dallara ayrılacak şekilde düzenlenmiştir. Kafa içinde, belirtilen bu dalların seyri boyunca herhangi bir yerdeki lezyonlar sinir felcine neden olabilir ve etiyolojik sebepler yetişkin ve çocuk yaş gruplarında farklılık gösterebilir. Konjenital nedenler, kraniyofarenjiyoma, travma, inflamatuvar ve enfeksiyöz nedenler, oftalmoplejik migren, malignite (lenfoma, lösemi), kraniyal anevrizmalar çocuk yaş grubundaki olası sebeplerdir. Literatürde çocuk yaş grubundaki okülomotor sinir dal felci vakalarının çoğu post-viral sebeplerle ilişkilendirilmiştir. Takiplerde bu olgularda mevcut klinik tablo kendiliğinden düzelmiştir. Bu vaka sunumu sol göz okulomotor sinir üst dal felci bulunan 8 yaşında bir kız çocuğuna ait idi. Altta yatan muhtemel nedenlerin araştırıldığı muayene ve tetkiklerde herhangi bir patoloji saptanmadı. Literatürdeki diğer vakalar dikkate alındığında hernekadar klinik araştırmalarda bir patoloji saptanmasa da spontan düzelme için hasta belli bir süre takip edildi. Fakat klinik bulgularında düzelme olmayan hastaya cerrahi tedavi uygulandı. Bu vaka literatürde çocuk yaş grubunda cerrahi ile başarılı şekilde tedavi edilen okulomotor sinir dal felci olan ilk çocuk hastadır.A An na ah ht ta ar r K Ke el li im me el le er r: :...

show abstract

“…Conventional rectus recession-resection is often not effective for strabismus due to rectus paralysis [1–3], though large recessions or periosteal fixation sutures can be effective in some cases [4–6]. Rectus paralysis can also be corrected by transposition or Jensen procedure of the rectus adjacent to the paralytic muscle [7–11].…”

Section: Introductionmentioning

confidence: 99%

Surgery for Complete Vertical Rectus Paralysis Combined with Horizontal Strabismus

Zou

Liu

et al. 2014

Journal of Ophthalmology

View full text Add to dashboard Cite

Aims. To report outcomes of the simultaneous surgical correction of vertical rectus paralysis combined with moderate-to-large angle horizontal strabismus. Methods. If a preoperative forced duction test was positive, antagonist muscle weakening surgery was performed, and then augmented partial rectus muscle transposition (APRMT) + partial horizontal rectus recession-resection was performed 2 months later. If a preoperative forced duction test was negative, APRMT + partial horizontal rectus recession-resection was performed. Antagonistic muscle weakening surgery and/or conventional recession-resection of the horizontal and/or vertical muscles of the contralateral eye was performed 2 months later, as needed. Results. Ten patients with a mean age of 22.3 ± 13.0 years were included and mean follow-up was 7.1 months. The mean vertical deviation that APRMT corrected was 21.4 ± 3.7 PD (prism diopter). The absolute deviation in horizontal significantly decreased from a preoperative value of 48.5 ± 27.4 PD to a value of 3.0 ± 2.3 PD 6 months postoperatively. The movement score decreased from a value of −5 ± 0 preoperatively to a value of −2.7 ± 0.8 at 6 months postoperatively. Conclusion. For patients with complete vertical rectus paralysis combined with a moderate- to-large angle of horizontal strabismus, combined APRMT and partial horizontal rectus recession-resection is safe and effective for correcting vertical and horizontal strabismus.

show abstract

Partial third cranial nerve palsy: clinical characteristics and surgical management

Cited by 19 publications

References 5 publications

Long term outcomes of strabismus surgery for third nerve palsy

Long term outcomes of strabismus surgery for third nerve palsy

Management of a Case with Isolated Oculomotor Nerve Palsy

Surgery for Complete Vertical Rectus Paralysis Combined with Horizontal Strabismus

Contact Info

Product

Resources

About