Caudal or cranial partial tenotomy of the horizontal rectus muscles in A and V pattern strabismus.

BACKGROUND: When performing a recession with vertical transposition of the insertions of the horizontal muscles in patients with A or V pattern strabismus, there is a risk of overcorrection in those with a relatively small angle of strabismus and almost-straight eyes in either upgaze or downgaze. AIM: To determine whether a caudal or cranial partial tenotomy of the horizontal rectus would be sufficient to reduce the horizontal angle in gaze ahead and minimise the risk of overcorrection in gaze direction, either up or down, with the smallest horizontal deviation. METHODS: A retrospective evaluation was performed of patients who had a caudal or cranial partial tenotomy of the horizontal rectus between January 1996 and January 2006. Patients were excluded if they had undergone previous surgery and or required additional oblique-muscle surgery. The reduction in the horizontal angle of strabismus in gaze ahead and in 25 degrees upgaze and downgaze was evaluated. RESULTS: Fifty-two patients were included, 16 with A-eso pattern, 12 with V-eso pattern, 7 with A-exo pattern, and 17 with V-exo pattern. Their age at operation ranged from 2 to 80 years (median 16). The mean (SD) reduction in the horizontal angle was 8.1 (4.5) degrees in the working direction of the transposition, either upgaze or downgaze, 6.2 (4.5) degrees in gaze ahead, and 3.3 (4.4) degrees out of the working direction. Four patients had to be reoperated in the short term, one because of overcorrection and three because of undercorrection. CONCLUSION: In patients with A or V pattern strabismus and an almost-straight eye position in either upgaze or downgaze, a partial tenotomy of the horizontal rectus is an effective treatment, with minimal risk of overcorrection.

Prosodic abilities in children with specific language impairment.

The purpose of this study was to compare the receptive and expressive prosodic abilities of specifically language-impaired children to those of a matched group of control normal-language children. Each subject group consisted of ten 4-year-olds, ten 5-year-olds and ten 6-year-olds. Subjects were administered two instruments which were designed for this purpose: the prosody imitation task and the emotion identification task. In the prosody imitation task subjects were required to imitate ten sentences with different linguistic and affective intonation contours. The emotion identification task required subjects to identify recordings of emotionally intoned sentences. Language-impaired children performed significantly less accurately on the imitation task but did not differ from normal-language children on the emotion identification task. Age was found to be a highly significant factor. On both tasks children performed better with increasing age. Results are discussed in reference to the developmental relationship between the child's learning of language and prosodic cues.

Eye movements of stuttering and nonstuttering children during silent reading.

During the silent reading of a 320-word passage, the eye movements of 22 grade school stutterers and 22 nonstutterers were recorded by means of a computer-controlled eye-marker. The recordings were made as a means of determining if the eye movements of the two groups differed and if the differences suggested that the young stutterers showed evidence of word-specific expectancy. Frame-by-frame analysis of the recordings revealed that the stuttering children displayed significantly more eye fixations and eye regressions than the nonstuttering children. The correlations among the different types of eye measures also varied between the subject groups. The differences observed were present despite the fact that the reading level of the two groups was age appropriate and the subjects sampled did not differ significantly in either reading errors or comprehension. These findings are like those previously found when stuttering and nonstuttering adults were similarly tested. They imply that expectancy is not the response province of older stutterers.