Abstract

Aim of the present study was to investigate the effectiveness of the Kestenbaum-Anderson principle in the surgical management of compensatory head posture (CHP) due to horizontal gaze palsy or acquired vertical nystagmus. Nine patients with horizontal gaze palsy who showed gaze preference towards the unaffected side and CHP underwent surgery on the horizontal rectus muscles according to the Kestenbaum-Anderson principle. Four patients with acquired vertical nystagmus and oscillopsia presenting with an eccentric rest position of the nystagmus and chin up or chin down CHP underwent surgery on the vertical rectus muscles. Positive results have been obtained in all cases. A tendency towards recurrence of the CHP has been noted in some patients. No hypercorrection was observed. Surgery based on the Kestenbaum-Anderson principle is a safe and effective procedure for patients with CHP due to supranuclear gaze palsy or acquired vertical nystagmus.

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