Improvement of surgical treatment of Duane syndrome in children

Abstract

To analyze the use of bifurcation of the lateral rectus muscle (LRM) in the surgical treatment of Duane syndrome (DS) in children. The analysis of surgical treatment involved 12 children with paralytic strabismus at the age of 8 to 17. The following research methods were conducted for all patients: the study of eye motility in different directions of gaze, the study of eyes position and the degree of deviation in different positions of gaze, the Bielschowsky test, the Park's three-step test, determination of the nature of torticollis, the forcing test - intraoperative forceps test, multislice computed tomography (MSCT) of the head and orbit, ultrasonography of the oculomotor muscles. All study children underwent bifurcation (Y-cleavage procedure) of LRM with recession in exo-DS in 17% of cases, without recession in eso-DS - 83% of cases, respectively. In all operated patients with Duane syndrome, the direction of LRM was compensated (downshoot and upshoot were eliminated). In a direct gaze, the correct position was achieved in 10 (83%) cases, in 2 (17%) the residual angle of up to 10 PD remained, and torticollis was eliminated in 9 (75%) patients. The method of LRM bifurcation - the procedure of dividing the muscle into two portions and changing its primary localization, accompanied by abnormalities (presence of deviation, retraction, anomalous vertical movements, limited ocular motility, etc.), - helps compensate for them, and provides cosmetic as well as functional improvement.