이상두위를 동반한 유아안진에서 Kestenbaum 술식의 효과

Abstract

We performed modified Kestenbaum procedures for correction of abnormal head position in 24 patients with infantile nystagmus. Preoperatively, the degree of head turn ranged from 15 degrees to 45 degrees. For 12 patients with head turn of 15 degrees ~ 30 degrees, 5-6-7-8 modified Kestenbaum procedures were performed. For 9 patients with head turn of 30-40, 20% augmented Kestenbaum procedures were performed and one patient with a 45degree head turn underwent a 30% augmented Kestenbaum procedure. Two patients with vertical chin down underwent 6-7mm recessions of both superior rectus muscles and 5mm resections of both inferior rectus muscles. In the follow-up of an average 12 months, 20 out of 24 patients showed no residual head turn or head turn less than 10 degrees. The modified Kestenbaum procedure could correct the abnormal head position successfully in 83% of infantile nystagmus with one operation. From the above results, we found that the proper amounts of Kestenbaum surgery were 5-6-7-8mm for 25 degrees or less than 25 degrees head turn, 20% augmentation for 30 degrees head turn and 30% or more augmentation for 40 degrees or more head turn.