ABSTRACT
Neste trabalho foi realizada uma revisão da literatura com o objetivo de integrar e compilar artigos disponíveis sobre a paralisia do VI nervo (abducente) para rever suas características clínicas, etiologias possíveis e os procedimentos clínicos, farmacológicos e cirúrgicos para seu tratamento. Primeiramente, descreve-se sua ação, localização, trajeto e possíveis lesões, depois seus principais fatores etiológicos para em seguida abordar-se o diagnóstico e o tratamento. Proposta de transposição de Carlson-Jampolsky isolada no tratamento cirúrgico da paralisia do VI nervo é também apresentada.
The authors review the basic aspects, etiology, clinical signs, diagnosis and treatment of the VI nerve palsy. Review the possible causes of abducent paralysis and location of determinant lesions. The clinical signs and clinical follow up are also observed in order to guide the etiology and therapeutic. The authors describe the clinical, pharmacological and surgical treatment. The authors emphasizes their proposal of VI nerve palsy correction using the isolated Carlson-Jampolsky transposition.
Subject(s)
Humans , Male , Female , Abducens Nerve , Abducens Nerve Diseases/diagnosis , Abducens Nerve Diseases/etiology , Abducens Nerve Diseases/therapy , ParesisABSTRACT
To report the outcomes of surgical and non-surgical treatment in sixth nerve paresis and palsy. This retrospective study was performed on hospital records of 33 consecutive patients [37 eyes] with sixth nerve dysfunction who were referred to Labbafinejad Medical Center from September 1996 to September 2006, and underwent surgical procedures or botulinum toxin injection. Patients were divided into three groups: group A had muscle surgery without transposition, group B underwent transposition procedures and group C received Botulinum toxin injection. Overall, 33 patients including 19 male and 14 female subjects with mean age of 20.4 +/- 17.2 years [range, 6 months to 66 years] were studied. Eye deviation improved from 50.3 +/- 16.8 to 6.0 +/- 9.8 prism diopters [PD] after the first operation and to 2.5 +/- 5.0 PD after the second operation in group A, from 56.9 +/- 24.3 to 5.5 +/- 16.0 PD after the first procedure and to almost zero following the second in group B, and from 44.3 +/- 10.5 to 15.0 +/- 20.0 PD 6 months following botulinum toxin injection in group C. Head posture and limitation of motility also improved significantly in all three groups. The overall rate of reoperations was 21%. Various procedures are effective for treatment of sixth nerve dysfunction; all improve ocular deviation, head turn and abduction deficit. The rate of reoperation is not high when treatment is appropriately selected according to clinical condition