Surgery for Vertical Abnormal Head Posture in Infantile Nystagmus

ABSTRACT

PURPOSE: The purpose of this study is to assess the effect of surgical management for infantile nystagmus with vertical abnormal head posture. METHODS: We performed surgical procedures to correct the vertical abnormal head posture of more than 10degrees in 6 patients with infantile nystagmus. One patient with the chin-up head posture was treated with recession of bilateral inferior rectus muscles and resection of bilateral superior rectus muscles, and 5 patients with the chin-down head posture were treated with recession of bilateral superior rectus muscles and resection of bilateral inferior rectus muscles. The pre- and post-operative measurements of the head posture were evaluated and compared with each other. RESULTS: Preoperatively, the degree of vertical head posture ranged from 10 to 30degrees, and 4 patients were with the 20~30degrees abnormal head posture. In the average follow-up period of 35.8 months, 5 patients (83.3%) showed less than 5degrees of chin-up or chin-down head posture. In one case, 20degrees left face turn was noted postoperatively. However, duction was full in all cases. CONCLUSIONS: These results suggest that the surgical management with bilateral vertical rectus muscles was effective for the correction of vertical abnormal head posture in infantile nystagmus.