目的:探讨婴幼儿眼性斜颈的临床特征,评估眼性斜颈早期手术效果。方法:对70例患儿进行回顾性分析。通过获取歪头试验、九方位眼球运动检查及眼底照相的结果,分析眼球肌肉异常的类型,对眼性斜颈做出定性诊断。采用计算机辅助斜视诊断技术,精确测量出水平斜视度数。对眼性斜颈患者中,上斜肌麻痹、下斜肌功能亢进者,行下斜肌部分切除术。其它原因引起的眼性斜颈,根据眼球肌肉异常类型的不同,设计不同的手术方法。对合并水平斜视者以计算机辅助下斜视测量软件测量出的水平斜视角度为根据,定量设计手术。随访时间6～12mo。结果:本组病例中,均找到眼部病因,以单纯性单眼上斜肌麻痹最常见,54例(77%)。全部患儿均接受手术治疗。一次手术后,单纯性单眼上斜肌麻痹患儿,6mo内治愈或改善者53例(占所有单纯性单眼上斜肌麻痹患儿的98%)。所有患儿6mo内治愈或改善者64例(91%),手术失败者6例。其中3例接受第二次手术,术后3例均治愈或改善。合并水平斜视者11例(16%),一次手术后水平斜视全部矫正。结论:婴幼儿眼性斜颈是一组包含不同类型病因的斜视。明确病因后尽早手术可获得满意头位矫正效果。

·AIM:To observe clinical features and effects of early surgery for ocular torticollis in infants.·METHODS:Clinical data of 70 infants with ocular torticollis were retrospectively analyzed.Preoperative exam of the Bielschowsky’s head tilt test,nine cardinal field of gaze and fundus photography,the ocular muscle anomaly was analyzed,then the reason of ocular torticollis was diagnosed.The angle horizontal strabismus was calculated by the computer-aided strabismus diagnosis technology.The patients with superior oblique palsy and overacting inferior oblique muscle,were treated with inferior oblique myectomy,The different ways of surgery were designed for other patients with different type of the strabismus.The quantity of horizontal strabismus surgery was decided by the computer-aided strabismus diagnosis technology for patients with horizontal strabismus.·RESULTS:All the patients can be found to be connected with the primary affection.The most common cause was simple unilateral superior oblique palsy,54 patients(77%).All patients were treated by surgery.After primary surgery,64 patiennts(91%)with head tilt were completely curd or improved in half a year,6 patients were failed.The three of 6 patients were treated with secondary surgery,all the three patients had their head tilt a complete cure or improved.All the horizontal strabismus was cured in primary surgery for 11 patients(16%)with horizontal strabismus.·CONCLUSION:There are different causes of ocular torticollis in infants,early surgery can obtain satisfactory results.·

R779.6

中国广东省科学技术厅基金资助项目(No.83036);中国广州市科学技术局基金资助项目(No.2005Z1-E0102)