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[PMID]: 29075763 [Au] Autor: Lee JE; Yang HK; Kim JH; Hwang JM [Ad] Endereço: Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea. [Ti] Título: Ocular Torsion According to Trochlear Nerve Absence in Unilateral Superior Oblique Palsy. [So] Source: Invest Ophthalmol Vis Sci;58(12):5526-5531, 2017 Oct 01. [Is] ISSN: 1552-5783 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Purpose: To investigate the relationship between objective ocular torsion and the presence or absence of the trochlear nerve in subjects with unilateral superior oblique palsy (SOP). Methods: A total of 159 subjects with congenital and acquired unilateral SOP were reviewed. Eighty-four subjects who had a normal trochlear nerve (present group) and 75 subjects without a trochlear nerve (absent group) were included. Cyclovertical motility parameters and objective ocular torsion were compared between groups, and factors related to ocular torsion were evaluated. Results: The degree of "net" excyclotorsion in the paretic eye was larger in the absent group compared to the present group (P = 0.002). The proportion of net excyclotorsion in the paretic eye was greater in the absent group (11% vs. 37%), while net incyclotorsion was greater in the present group (41% vs. 23%) (P < 0.001). Net excyclotorsion of the paretic eye was associated with absence of the trochlear nerve (P < 0.001) and smaller size of the paretic SO (P < 0.001). Net incyclotorsion of the paretic eye was related with a normal trochlear nerve (P = 0.005), larger size of the paretic SO (P = 0.002), and greater hypertropia during ipsilateral gaze (P = 0.024). Conclusions: The status of the trochlear nerve, paretic SO size, and hypertropia during ipsilateral gaze which reflects the tensile strength of the ipsilateral superior rectus, significantly contribute to ocular torsion in unilateral SOP. [Mh] Termos MeSH primário: Movimentos Oculares/fisiologia Transtornos da Motilidade Ocular/etiologia Músculos Oculomotores/fisiopatologia Doenças do Nervo Troclear/congênito Nervo Troclear/anormalidades [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Idoso de 80 Anos ou mais Criança Pré-Escolar Feminino Seres Humanos Imagem por Ressonância Magnética Masculino Meia-Idade Transtornos da Motilidade Ocular/diagnóstico Transtornos da Motilidade Ocular/fisiopatologia Músculos Oculomotores/inervação Estudos Retrospectivos Nervo Troclear/diagnóstico por imagem Doenças do Nervo Troclear/complicações Doenças do Nervo Troclear/fisiopatologia Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171102 [Lr] Data última revisão: 171102 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171028 [St] Status: MEDLINE [do] DOI: 10.1167/iovs.17-22452

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[PMID]: 28687220 [Au] Autor: Nash DL; Hatt SR; Leske DA; May L; Bothun ED; Mohney BG; Brodsky MC; Holmes JM [Ad] Endereço: Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota; Department of Ophthalmology, Gundersen Health System, La Crosse, Wisconsin. [Ti] Título: One- Versus Two-Muscle Surgery for Presumed Unilateral Fourth Nerve Palsy Associated With Moderate Angle Hyperdeviations. [So] Source: Am J Ophthalmol;182:1-7, 2017 Oct. [Is] ISSN: 1879-1891 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: To compare 1-muscle vs 2-muscle surgery for moderate-angle hyperdeviations owing to presumed unilateral fourth nerve palsy. DESIGN: Retrospective chart review. METHODS: Seventy-three patients (aged 5-86 years) underwent either 1- or 2-muscle surgery at our institution for moderate hyperdeviation owing to presumed unilateral fourth nerve palsy, measuring 14-25 prism diopters (PD) in straight-ahead gaze at distance fixation. Six-week and 1-year motor success was defined as zero vertical deviation or 1-4 PD undercorrection at distance, overcorrection as any reversal of hypertropia, and undercorrection as >4 PD. Diplopia success was defined as no diplopia, or only rarely for distance straight ahead and reading. RESULTS: Twenty-eight patients underwent 1-muscle surgery, and 45 patients underwent 2-muscle surgery. Motor success was similar (64% vs 67%, P > .99 at 6 weeks; 47% vs 55%, P = .8 at 1 year, n = 46), but there were more undercorrections at 6 weeks with 1-muscle surgery (36% vs 16%, P = .09) and more overcorrections at 6 weeks with 2-muscle surgery (0% vs 18%, P = .02). Diplopia success was also somewhat similar between 1- and 2-muscle surgery at 6 weeks (73% vs 60%, P = .5) and 1 year (45% vs 59%, P = .5). CONCLUSION: For moderate-angle hyperdeviations owing to presumed unilateral fourth nerve palsy, there appears no clear advantage of 2-muscle surgery for motor outcomes. Diplopia success was similar between 1- and 2-muscle surgery, owing to a greater number of less symptomatic undercorrections with 1-muscle surgery and a smaller number of more symptomatic overcorrections with 2-muscle surgery. [Mh] Termos MeSH primário: Diplopia/cirurgia Músculos Oculomotores/cirurgia Procedimentos Cirúrgicos Oftalmológicos Estrabismo/cirurgia Doenças do Nervo Troclear/cirurgia [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Idoso de 80 Anos ou mais Criança Pré-Escolar Diplopia/etiologia Diplopia/fisiopatologia Feminino Seres Humanos Masculino Meia-Idade Estudos Retrospectivos Estrabismo/etiologia Estrabismo/fisiopatologia Doenças do Nervo Troclear/complicações Doenças do Nervo Troclear/fisiopatologia Visão Binocular/fisiologia [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171003 [Lr] Data última revisão: 171003 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170709 [St] Status: MEDLINE

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[PMID]: 28434965 [Au] Autor: Nesvick CL; Perry A; Graffeo CS; Raghunathan A; Hammack JE; Van Gompel JJ [Ad] Endereço: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA. [Ti] Título: Trochlear Schwannoma Presenting with Isolated Trigeminal Neuralgia. [So] Source: World Neurosurg;103:951.e13-951.e20, 2017 Jul. [Is] ISSN: 1878-8769 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Schwannomas arising from the cranial nerves controlling extraocular eye movements are very rare and usually present with some degree of diplopia. CASE PRESENTATION: We report a 50-year-old woman who presented with isolated left-sided trigeminal neuralgia of 6 months' duration. Imaging demonstrated a homogeneously enhancing mass in the left ambient cistern, and the patient was brought to the operating room for resection. A retrosigmoid approach was used, and the mass was directly visualized arising from the trochlear nerve and compressing the dorsal root entry zone of the trigeminal nerve. A gross total resection of the mass was achieved, and microvascular decompression of the trigeminal nerve was performed. The tumor was pathologically confirmed as a schwannoma. At 3-month follow-up, the patient's facial pain was resolved, and her extraocular eye movements were intact. CONCLUSIONS: A total of 32 pathology-confirmed cases of trochlear schwannoma have been previously reported in the English-language literature. Most of these tumors arose from the cisternal segment of the nerve, and most patients presented with frank trochlear nerve palsy on exam. We report the first case of trochlear schwannoma presenting with isolated trigeminal neuralgia. [Mh] Termos MeSH primário: Neoplasias dos Nervos Cranianos/complicações Neurilemoma/complicações Neuralgia do Trigêmeo/etiologia Doenças do Nervo Troclear/complicações [Mh] Termos MeSH secundário: Neoplasias dos Nervos Cranianos/diagnóstico por imagem Neoplasias dos Nervos Cranianos/patologia Neoplasias dos Nervos Cranianos/cirurgia Feminino Seres Humanos Imagem por Ressonância Magnética Cirurgia de Descompressão Microvascular Meia-Idade Neurilemoma/diagnóstico por imagem Neurilemoma/patologia Neurilemoma/cirurgia Procedimentos Neurocirúrgicos Neuralgia do Trigêmeo/cirurgia Doenças do Nervo Troclear/diagnóstico por imagem Doenças do Nervo Troclear/patologia Doenças do Nervo Troclear/cirurgia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170925 [Lr] Data última revisão: 170925 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170425 [St] Status: MEDLINE

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[PMID]: 28366647 [Au] Autor: Bata BM; Leske DA; Holmes JM [Ad] Endereço: Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota. [Ti] Título: Adjustable Bilateral Superior Oblique Tendon Advancement for Bilateral Fourth Nerve Palsy. [So] Source: Am J Ophthalmol;178:115-121, 2017 Jun. [Is] ISSN: 1879-1891 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: Bilateral fourth nerve palsy may be symmetric or asymmetric with combined vertical and excylotropic deviations and so there may be an advantage to independent adjustment of vertical and torsional components. We report a surgical technique that allows such independent adjustment. DESIGN: Retrospective interventional case series. METHODS: Fifteen patients, aged 17-73 years, underwent adjustable bilateral superior oblique tendon advancements for bilateral fourth nerve palsy: 11 symmetric (≤2 prism diopters [pd] hyperdeviation in straight-ahead gaze) and 4 asymmetric. Motor alignment was assessed with double Maddox rods and prism and alternate cover tests preoperatively, pre- and postadjustment, and 6 weeks postoperatively. RESULTS: Preoperative torsion ranged from 7 to 30 degrees excyclotropia (mean 17 ± 7 degrees) and hyperdeviation from 0 to 10 pd. Preadjustment torsion ranged from 5 degrees excyclotropia to 40 degrees incyclotropia, and hyperdeviation from 0 to 8 pd. Twelve of the 15 patients (80%) were adjusted to a target of 0 pd hyperphoria and 10 degrees incyclotropia (actual mean 9 degrees incyclotropia, range 2-13 degrees incyclotropia). At 6 weeks postoperatively there was expected excyclodrift (to mean 4 degrees excyclotropia, range 0 degrees incyclotropia to 15 degrees excyclotropia), but 13 (87%) had 5 degrees or less excyclotropia and 14 (93%) had 2 pd or less hyperdeviation. Mean torsional correction from preoperative to preadjustment was 31 ± 14 degrees (P < .0001), and from preoperative to 6 weeks was 13 ± 6 degrees (P < .0001). CONCLUSIONS: Adjustable bilateral superior oblique tendon advancement allows independent control of torsional and vertical components of the deviation, and therefore may be useful in cases of bilateral superior oblique palsy. [Mh] Termos MeSH primário: Movimentos Oculares/fisiologia Músculos Oculomotores/cirurgia Procedimentos Cirúrgicos Oftalmológicos/métodos Estrabismo/cirurgia Tendões/cirurgia Doenças do Nervo Troclear/cirurgia Visão Binocular/fisiologia [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Feminino Seguimentos Seres Humanos Masculino Meia-Idade Músculos Oculomotores/fisiopatologia Período Pós-Operatório Estrabismo/etiologia Estrabismo/fisiopatologia Fatores de Tempo Doenças do Nervo Troclear/complicações Doenças do Nervo Troclear/fisiopatologia Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170721 [Lr] Data última revisão: 170721 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170404 [St] Status: MEDLINE

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[PMID]: 28292276 [Au] Autor: Lee DC; Lee SY [Ad] Endereço: Department of Ophthalmology, Keimyung University Dongsan Medical Center, Keimyung University school of Medicine, Daegu, 41931, South Korea. [Ti] Título: Effect of modified graded recession and anteriorization on unilateral superior oblique palsy: a retrospective study. [So] Source: BMC Ophthalmol;17(1):27, 2017 Mar 14. [Is] ISSN: 1471-2415 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Several inferior oblique (IO) weakening methods exist for correction of superior oblique palsy (SOP). A previously reported method involved recession and anteriorization according to IO overaction (IOOA) grade, which might be subjective and cause upgaze limitation and opposite vertical strabismus. Therefore, this study attempted to examine the efficacy of modified graded recession and anteriorization of the IO muscle in correction of unilateral SOP without resulting in upgaze limitation or opposite vertical strabismus. METHODS: A total of 26 patients (male, 16; female, 10; age: 3-40 years) with SOP and head tilt or diplopia underwent modified graded recession and anteriorization. Patients were grouped by the position at which the IO muscle was attached inferior/temporal to the lateral border of the inferior rectus (IR) as follows: (1) 7.0/2.0 mm (4 patients), (2) 6.0/2.0 mm (3 patients), (3) 5.0/2.0 mm (3 patients), (4) 4.0/2.0 mm (11 patients), (5) 3.0/0.0 mm (2 patients), and (6) 2.0/0.0 mm (3 patients). Recession and anteriorization were matched to vertical deviation in the primary position at far distance. Remaining diplopia, head tilt, vertical deviation (≤3 prism diopter (PD), excellent; 4-7 PD, good; and ≥ 8 PD, poor), upgaze limitation, and opposite vertical strabismus were evaluated. RESULTS: The average pre and postoperative 1-year vertical deviation angles in the primary position at far distance were 15.0 ± 5.6 PD and 1.2 ± 2.0 PD, respectively. At 1 year post-surgery, the vertical deviation angles were reduced by 6.8-21.0 PD from those at baseline. Few patients exhibited remaining head tilt, diplopia, upgaze limitation, or opposite vertical strabismus. Correction of hypertropia was excellent in 22 and good in 4 patients. CONCLUSIONS: Modified graded recession and anteriorization of the IO muscle is an effective surgical method for treating unilateral SOP. It exhibits good results and reduces the incidence of opposite vertical strabismus. [Mh] Termos MeSH primário: Movimentos Oculares/fisiologia Músculos Oculomotores/cirurgia Procedimentos Cirúrgicos Oftalmológicos/métodos Doenças do Nervo Troclear/cirurgia Visão Binocular [Mh] Termos MeSH secundário: Adolescente Adulto Criança Pré-Escolar Diplopia/etiologia Diplopia/fisiopatologia Diplopia/cirurgia Feminino Seguimentos Seres Humanos Masculino Músculos Oculomotores/fisiopatologia Estudos Retrospectivos Fatores de Tempo Doenças do Nervo Troclear/fisiopatologia Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170816 [Lr] Data última revisão: 170816 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170316 [St] Status: MEDLINE [do] DOI: 10.1186/s12886-017-0422-6

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[PMID]: 28277775 [Au] Autor: Morillon P; Bremner F [Ad] Endereço: F1 Doctor, Department of General Medicine, Maidstone and Tunbridge Wells NHS Trust, Maidstone. [Ti] Título: Trochlear nerve palsy. [So] Source: Br J Hosp Med (Lond);78(3):C38-C40, 2017 Mar 02. [Is] ISSN: 1750-8460 [Cp] País de publicação: England [La] Idioma: eng [Mh] Termos MeSH primário: Músculos Oculomotores/anatomia & histologia Doenças do Nervo Troclear/diagnóstico Nervo Troclear/anatomia & histologia [Mh] Termos MeSH secundário: Diplopia/etiologia Seres Humanos Músculos Oculomotores/inervação Exame Físico Doenças do Nervo Troclear/complicações [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170615 [Lr] Data última revisão: 170615 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170310 [St] Status: MEDLINE [do] DOI: 10.12968/hmed.2017.78.3.C38

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[PMID]: 28009406 [Au] Autor: Erkan Turan K; Taylan Sekeroglu H; Koc I; Kilic M; Sanac AS [Ad] Endereço: Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara - Turkey. [Ti] Título: The frequency and causes of abnormal head position based on an ophthalmology clinic's findings: is it overlooked? [So] Source: Eur J Ophthalmol;27(4):491-494, 2017 Jun 26. [Is] ISSN: 1724-6016 [Cp] País de publicação: Italy [La] Idioma: eng [Ab] Resumo: PURPOSE: To determine the frequency of abnormal head position (AHP) and identify the underlying causes in patients who presented to an ophthalmology clinic due to any ophthalmologic complaint. METHODS: The medical records of patients who presented with any ophthalmologic symptoms during a 6-month period were prospectively evaluated. In all, 2,710 patients (1,492 female and 1,218 male) aged 6 months-91 years were included in the study. Each patient underwent complete ophthalmologic evaluation. RESULTS: Among the 2,710 patients, 30 (1.1%) (7 female and 23 male) with a mean age of 14.62 ± 17.45 years (range 6 months-60 years) had AHP. In total, 24 (80%) of the patients with AHP were aged ≤16 years. The initial complaint in the patients with AHP was ocular misalignment in 18 (60%) patients, AHP in 4 (13.3%), abnormal ocular movements in 4 (13.3%), double vision in 3 (10%), and droopy eyelid in 1 (3.3%). Comitant strabismus, nystagmus, and Duane syndrome were the most common causes of AHP. Other diagnoses included fourth nerve palsy, sixth nerve palsy, Brown syndrome, congenital muscular torticollis, ptosis, and blowout orbital fracture. CONCLUSIONS: The leading underlying causes of AHP in patients who presented to an ophthalmology clinic were ocular and treatable. Of note, in only a minority of these patients AHP was the initial presenting complaint. Clinicians must be aware that observation of any head position that is not normal should prompt additional investigation, as the underlying pathology can cause treatable morbidity or in rare instances mortality, such as in cases of acute cranial nerve palsy. [Mh] Termos MeSH primário: Oftalmopatias/complicações Cabeça Anormalidades Musculoesqueléticas/etiologia Transtornos da Motilidade Ocular/complicações Postura/fisiologia Transtornos da Visão/complicações [Mh] Termos MeSH secundário: Doenças do Nervo Abducente/complicações Adolescente Adulto Idoso Idoso de 80 Anos ou mais Criança Pré-Escolar Feminino Seres Humanos Lactente Masculino Meia-Idade Nistagmo Patológico Torcicolo/complicações Doenças do Nervo Troclear/complicações Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170809 [Lr] Data última revisão: 170809 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161224 [St] Status: MEDLINE [do] DOI: 10.5301/ejo.5000908

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[PMID]: 27992486 [Au] Autor: Komori M; Suzuki H; Hikoya A; Sawada M; Hotta Y; Sato M [Ad] Endereço: Department of Ophthalmology, Hamamatsu University School of Medicine, Hamamatsu, Japan. [Ti] Título: Evaluation of Surgical Strategy Based on the Intraoperative Superior Oblique Tendon Traction Test. [So] Source: PLoS One;11(12):e0168245, 2016. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: To clarify the efficacy of a surgical strategy based on the superior oblique tendon traction test. METHODS: A retrospective chart review was performed between January 2002 and June 2015. During that period, a single inferior oblique muscle (IO) myectomy and a combined IO myectomy and superior oblique muscle (SO) tuck procedure were performed based on SO tendon looseness as revealed by a traction test. The surgical effects of both procedures and the number of operations were analyzed. RESULTS: Sixty-five cases were retrieved. Seventy-four surgeries were required. The IO myectomy and simultaneous groups included 48 and 17 cases, respectively. Pre-operative vertical deviation was significantly lower in the IO myectomy (11.8 prism diopters) than in the simultaneous (27.2 prism diopters; Mann-Whitney U-test, P < 0.001) group. The mean induced changes were 9.4 prism diopters and 21.6 prism diopters in the IO myectomy and simultaneous groups, respectively, and the postoperative vertical deviation was not significantly different. On average, 1.13 and 1.18 surgeries per patient were performed in the IO myectomy and simultaneous groups, respectively. CONCLUSION: The simultaneous surgery of inferior oblique myectomy and superior oblique tuck is safe and effective for treating large angle of congenital/idiopathic superior oblique palsy with a lax superior oblique tendon, as determined by the traction test. [Mh] Termos MeSH primário: Monitorização Intraoperatória/métodos Nervo Oculomotor/fisiologia Procedimentos Cirúrgicos Oftalmológicos/métodos Tendões/fisiologia Tração Doenças do Nervo Troclear/congênito [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Criança Pré-Escolar Seres Humanos Lactente Meia-Idade Contração Muscular Músculos Oculomotores/fisiologia Músculos Oculomotores/cirurgia Nervo Oculomotor/cirurgia Estudos Retrospectivos Tendões/cirurgia Doenças do Nervo Troclear/cirurgia Adulto Jovem [Pt] Tipo de publicação: EVALUATION STUDIES; JOURNAL ARTICLE [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170705 [Lr] Data última revisão: 170705 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161220 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0168245

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[PMID]: 27851717 [Au] Autor: Jeong SH; Kim SH; Lee SH; Park SH; Kim HJ; Kim JS [Ad] Endereço: Department of Neurology (S-HJ), Chungnam National University Hospital, Daejeon, Korea; Department of Neurology (S-HK, S-HP, J-SK), Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Neurology (S-HL), Chonnam National University Medical School, Gwangju, Korea; and Department of Biomedical Laboratory Science (H-JK), Kyungdong University, Goseong-gun, South Korea. [Ti] Título: Central Trochlear Palsy: Report of Two Patients With Ipsilesional Palsy and Review of the Literature. [So] Source: J Neuroophthalmol;36(4):377-382, 2016 Dec. [Is] ISSN: 1536-5166 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: The trochlear (fourth) nerve is the only cranial nerve that decussates before emerging from the posterior aspect of the brainstem. Lesions involving the trochlear nucleus or fascicles mostly give rise to contralesional superior oblique palsy (SOP). METHODS: We report 2 patients with SOP on the side of intraaxial lesions with a literature review on central trochlear palsy. RESULTS: The lesions are more commonly located posterior to the cerebral aqueduct in patients with ipsilesional SOP than in those with contralesional SOP. CONCLUSIONS: Intraaxial lesions may cause ipsilesional or contralesional SOP depending on the lesion location along the course of trochlear fascicle in the brainstem. [Mh] Termos MeSH primário: Movimentos Oculares/fisiologia Músculos Oculomotores/fisiopatologia Doenças do Nervo Troclear/diagnóstico Nervo Troclear/patologia [Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais Feminino Seres Humanos Imagem por Ressonância Magnética Meia-Idade Músculos Oculomotores/diagnóstico por imagem Doenças do Nervo Troclear/fisiopatologia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170901 [Lr] Data última revisão: 170901 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161117 [St] Status: MEDLINE

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[PMID]: 27799580 [Au] Autor: Wang Q; Flanders M [Ad] Endereço: From the Department of Ophthalmology, University of Montreal, Montreal, Quebec. [Ti] Título: Surgical Management of Unilateral Superior Oblique Palsy: Thirty Years of Experience. [So] Source: Am Orthopt J;66(1):79-86, 2016 Jan. [Is] ISSN: 0065-955X [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: INTRODUCTION AND PURPOSE: We describe the clinical characteristics of 252 patients with unilateral superior oblique palsy who underwent strabismus surgery. We assess if a predetermined surgical strategy, based on preoperative alignment and motility measurements, was effective in treating these patients. On this basis, the patients were divided into three different treatment groups. METHODS: Two-hundred fifty-two patients were identified retrospectively and classified into three groups according to the performed procedures: 1) inferior oblique weakening; 2) inferior rectus recession; 3) combined inferior oblique weakening and inferior rectus recession. Demographic and clinical data were recorded. Criteria for surgical success included good postoperative alignment (distance, primary position alignment ≤5 ), and improvement of diplopia and of abnormal head posture. Subgroup analyses of surgical outcome were performed for small (<12 ) versus large (>20 ) preoperative hypertropia in the group that underwent inferior oblique weakening, and for inferior oblique disinsertion-myectomy versus inferior oblique recession. RESULTS: Mean forced primary position (PP) hypertropia decreased from 14.3 (range 3-37 ) to 4.5 (range 0-30 ) in Group 1, from 13 (range 1-30 ) to 2 (range -20-20 ) in Group 2, and from 25.7 (range 6-40 ) to 1.3 (range -12-18 ) in Group 3. Group 1 had the lowest re-operation rate (7.6%), followed by Group 2 (16%) and Group 3 (25.9%). Final surgical success rates were similar in three groups. Inferior oblique weakening was more predictable for small primary position hypertropia, but still yielded 85% success rate in large deviations. Inferior oblique disinsertion-myectomy resulted in more favorable results than inferior oblique recession (P < 0.05). CONCLUSION: When a predetermined surgical strategy is applied to individual patients with unilateral superior oblique palsy, excellent functional improvement can be achieved in the majority of patients. [Mh] Termos MeSH primário: Músculos Oculomotores/cirurgia Estrabismo/cirurgia Doenças do Nervo Troclear/cirurgia [Mh] Termos MeSH secundário: Seres Humanos Estudos Retrospectivos [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 170316 [Lr] Data última revisão: 170316 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161102 [St] Status: MEDLINE

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1			PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2
2	and or and not		PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2
3	and or and not		PalavrasDescritor de assuntoDescritor de assunto primárioLimitesAutorPalavras do títuloPalavras do resumoIdiomaPaís de publicaçãoNome de substânciaNome de pessoa como assuntoRevistaAssunto de RevistaISSNTipo de publicaçãoIdentificador únicoMês de entradaAno de publicaçãoTexto completoAtualização por classeCategoria DeCSCategoria DeCS explodidaCategoria CID-10SubSetsPais de AfiliaçãoAfiliaçãoAfiliação 2

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