Article Text

PDF
Clinical science
Residual torticollis in patients after strabismus surgery for congenital superior oblique palsy
  1. F H S Lau1,
  2. D S P Fan1,
  3. K K W Sun2,
  4. C B O Yu1,
  5. C Y Wong1,
  6. D S C Lam1
  1. 1
    Hong Kong Eye Hospital, Department of Ophthalmology & Visual Sciences, the Chinese University of Hong Kong, Kowloon, Hong Kong, People’s Republic of China
  2. 2
    Tuen Mun Hospital, Department of Orthopedics and Traumatology, Tuen Mun, New Territories, Hong Kong, People’s Republic of China
  1. Correspondence to Dr D S P Fan, 3rd Floor, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong, People’s Republic of China; dorothyfan{at}cuhk.edu.hk

Abstract

Aim: To study postoperative residual vertical deviation and abnormal head posture (AHP) after surgical treatment for congenital superior oblique palsy (SOP).

Method: Children with both SOP and AHP who underwent extraocular muscle surgery for correction of AHP were recruited. The patients received complete ophthalmic and orthopaedic examinations. Residual AHP was classified according to severity of face turn, head tilt and chin elevation.

Results: Thirty-two children with mean age at operation of 82.6 months were recruited, with mean follow-up of 37.9 months. Of these children, 65.6% had a postoperative vertical deviation of less than three prism dioptres. In addition, 34.4% patients had resolved (0°), 34.4% had mild (1°–10°), and 31.3% had significant residual torticollis (>10°). Of the patients with significant residual torticollis, 33.3% had ocular causes. The mean age at operation for the patients with residual torticollis (95.9 months) was older than those without torticollis (79.9 months) (p = 0.018). Residual torticollis was found to be related to sternocleidomastoid muscle tightness (p = 0.013).

Conclusion: The success rate for eliminating significant AHP after strabismus surgery for patients with congenital SOP was 68.8%. Early surgery was associated with a better outcome. Association was also found between sternocleidomastoid tightness and AHP. A multidisciplinary approach is recommended in the management of torticollis as ophthalmic and orthopaedic comorbidities can coexist.

Statistics from Altmetric.com

Footnotes

  • Funding None

  • Competing interests None declared.

  • Ethics approval Obtained

  • Patient consent Informed consent was taken from all legal guardians to participants in this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • At a glance
    Harminder S Dua Arun D Singh