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Modified Kestenbaum surgery for correction of abnormal head posture in infantile nystagmus: outcome in 63 patients with graded augmentaton

 Lee, I S  ;  Lee, J B  ;  Kim, H S  ;  Lew, H  ;  Han, S H 
 Binocular Vision & Strabismus Quarterly, Vol.15(1) : 53-58, 2000 
Journal Title
Binocular Vision & Strabismus Quarterly
Issue Date
Adolescent ; Adult ; Child ; Child, Preschool ; Electrooculography ; Eye Movements ; Female ; Head Movements* ; Humans ; Male ; Nystagmus, Congenital/physiopathology ; Nystagmus, Congenital/surgery* ; Oculomotor Muscles/physiopathology ; Oculomotor Muscles/surgery* ; Posture* ; Retrospective Studies ; Treatment Outcome
Adolescent ; Adult ; Child ; Child ; Preschool ; Electrooculography ; Eye Movements ; Female ; Head Movements ; Humans ; Male ; Nystagmus ; Congenital ; physiopathology ; surgery ; Oculomotor Muscles ; Posture ; Retrospective Studies ; Treatment Outcome
PURPOSE: To analyze the surgical effect of modified Kestenbaum surgery and show how to determine the amount of appropriate augmentation for correction of abnormal head posture in infantile nystagmus.
METHODS: We reviewed the records of 63 patients with infantile nystagmus who required surgery for a significant face turn and who were followed for at least five months after surgery. Group 1, consisting of 29 patients, received Parks' modification of the standard Kestenbaum procedure (the 5-6-7-8 mm procedure); Group 2, 32 patients, received a 20% augmentation of the original Parks recommendation; and Group 3, 2 patients, received a 30% augmentation of the original Parks procedure. Pre-and postoperative measurements with electro-oculography (EOG) using Nicolet Compact Four/CA 2000 were made.
RESULTS: The average preoperative face turn in the 63 patients with horizontal nystagmus was 31.9 degrees with an average postoperative face turn of 5.2 degrees. The average net change in face turn was 26.7 degrees. The average duration of time from surgery to final examination was thirteen months. Fifty-six out of 63 patients (89%) achieved a straight head position or a residual face turn of 10 degrees or less.
CONCLUSION: A Parks' modified Kestenbaum procedure, with appropriate graded augmentation up to 30% is effective for the correction of abnormal head posture in infantile nystagmus without the need for larger augmentations.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Jong Bok(이종복)
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