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| 題 名 | 隱蔽型雙側性上斜肌麻痺之發生率及臨床特徵=Incidence and Clinical Features of Masked Bilateral Superior Oblique Palsy |
|---|---|
| 作 者 | 沈秉衡; 劉士傑; | 書刊名 | 中華民國眼科醫學會雜誌 |
| 卷 期 | 36:1 1997.03[民86.03] |
| 頁 次 | 頁19-23 |
| 分類號 | 416.755 |
| 關鍵詞 | 隱蔽型雙側性上斜肌麻痺; Masked bilateral superior oblique palsy; Bielshowsky test; Alternate parism cover test; Fundus extorsion; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 單側性上斜肌麻痺及雙側性上斜肌麻痺在預後及治療方面均有所不同,因此如何 在二者間作一鑑別診斷是非常重要的。我們收集了 54 位在臺中榮總診斷為上斜肌麻痺的病 人,來評估隱蔽型雙側性上斜肌麻痺的發生率及臨床特徵。隱蔽型雙側性上斜肌麻痺的發性 率是 22.4 % (11/49)。上斜肌麻痺手術治療後,對側的上斜肌麻痺被〞顯露〞出來的時間 ,範圍從 10 天到 16 個月不等,平均是 4.9 個月。 外傷造成上斜肌麻痺的百分比,在單 側性、隱蔽型雙側性及雙側性上斜肌麻痺這三組中,分別為 13 %、9 %和 40 %。上斜肌 麻痺相關的症狀依序為傾斜頭位、外斜視、複視、內斜視、眼球震顱和弱視。另外,當頭部 傾斜至麻痺側及非麻痺側,所測得上斜視的角度,在單側性及隱蔽型雙側性上斜肌麻痺這二 組病人分別為 19.3、6.1 和 19.1、 4.0PD。 讓病患視線分別固定於一近物及一遠物, 用 alternate prism cover test 所測上斜視的角度, 在單側性及隱蔽型雙側性上斜肌麻痺這 二組病人分別為 14.0、15.6PD 及 9.0、9.3PD,但並無統計學上的差異。 單側性及隱蔽型 雙側性上斜肌麻痺的臨床特徵是非常的類似,以至於手術前無法在二者間作一正確之鑑別診 斷。因此,永遠認定上斜肌麻痺是雙側性的,直到證明不是為止。 |
| 英文摘要 | Unilateral and bilateral superior oblique palsy (SOP) differ in prognosis and treatment, so it is very important to differentiate between these two types of SOP. Fifty-four consecutive patients with SOP seen at Taichung Veterans General Hospital were reviewed to evaluate the incidence and clinical features of masked bilateral SOP (MBSOP). Incidence of MBSOP is 22.4% (11/49). The time interval of "unmasking" of the contralateral SOP after the first surgery ranged from 10 days to 16 months (mean 4.9 months). Percentage of traumatic SOP is 13%, 9% and 40% in unilateral SOP (USOP), MBSOP and bilateral SOP (BSOP) respectively. Symptoms and signs associated with SOP are head tilt posture, XT, diplopia, ET, nystagmus and amblyopia. Prism diopters of hypertropia when head tilted to the paretic/nonparetic side were 19.3/6.1 and 19.1/4.0 in USOP and MBSOP. The results of APCT when patients fixed at a near/distant object showed 14.0/15.6 and 9.0/9.3 prism diopters of hypertropia in USOP and MBSOP but no statistical differences were noted. Clinical features of unilateral and masked bilateral SOP are so similar that differential diagnosis cannot be made before operation. So, always assume SOP is bilateral until proven otherwise. |
本系統中英文摘要資訊取自各篇刊載內容。