the treatment method of extraocular muscle hypoplasia, how to do with extraocular muscle hypoplasia, and medication for extraocular muscle hypoplasia
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Diagnosis and treatment knowledge of extraocular muscle hypoplasia
Visiting department: ophthalmology treatment cost: about (5000-10000 yuan) in the top three hospitals in the city. Cure rate: treatment cycle: treatment method: surgical treatmentGeneral treatment of extraocular muscle hypoplasia
1. The treatment of congenital absence of total extraocular muscles can only be partially corrected. Ptosis can be done with internal lifting or suture lifting, because its ptosis is caused by the absence of levator palpebrae superioris muscle, so it is impossible to shorten the levator palpebrae superioris muscle. If the eyeball is oblique, periosteal suture fixation at the outer edge of the orbit can be done. If the mandible is obviously lifted up, the bulbar conjunctiva and fascia below the two eyeballs can move back synchronously, and periosteal suture fixation at the upper edge of the orbit can be used to shift the eyeballs upward to correct the compensatory head position.
2. The treatment of congenital partial extraocular muscle absence is mainly the correction of inferior rectus muscle absence, and there are seven methods as follows:
(1) Superior rectus muscle weakening: Generally, as the first operation, recession is commonly used. Cui Guoyi used rectus muscle suspension recession, and the recession was 8 ~ 10mm, but limited to 10mm. If the superior rectus muscle contracture is obvious or fibrosis is feasible, tendon amputation is feasible.
(2) Rectus muscle transplantation: At present, rectus muscle transplantation is widely used at home and abroad, including Hummelsheim operation (transplanting the inferior 1/2 tendon of medial and lateral rectus muscles to the proper attachment of inferior rectus muscles), Knapp operation (suturing the whole tendon of medial and lateral rectus muscles to the proper attachment of inferior rectus muscles) or pill tail operation (moving the end of medial and lateral rectus muscles down to the nasal and temporal edge of the end of inferior rectus muscles). The above methods are mainly used for the absence of inferior rectus muscle without horizontal strabismus. As the second operation after weakening the superior rectus muscle, the purpose is to correct the superior oblique by changing the attachment position of the medial and lateral rectus muscles.
(3) Suture fixation of periosteum of infraorbital margin: The method is to place two traction sutures on the superficial sclera below the inferior rectus muscle attachment or internal rectus tendon to suture and fix them on the periosteum of infraorbital margin from subconjunctiva.
(4) Microvascular separation and partial cross-transposition of internal and external rectus muscles: The method is to separate and preserve the superior, internal and external rectus muscles while weakening the superior rectus muscles, and cross-transplant the inferior 1/3 muscle bundles of the internal and external rectus muscles to the sclera at the attachment of the inferior rectus muscles.
(5) Surgery with horizontal strabismus: If there are exotropia and medial strabismus, the horizontal muscles should be reclassified, amputated or reclassified plus amputated according to the degree of strabismus at the same time of muscle transplantation.
(6) Surgery with oblique muscle: The method is to transfer the inferior oblique muscle forward and sew it to the superior sclera in the infratemporal quadrant or to transfer the inferior oblique muscle backward and forward.
(7) Excise and shorten the fascia and bulbar conjunctiva below the eyeball: make the eyeball turn downward and correct the upward obliquity.
3. Treatment of congenital extraocular muscle attachment abnormality This abnormality can show different types of strabismus. If abnormal extraocular muscle attachment is found during operation, it should be reduced in principle, and the eye position should be observed during operation. If there is exotropia or esotropia, horizontal muscle surgery should be performed at the same time.
Second, the prognosis
The absence of all extraocular muscles can't restore eye movement.
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