上下直筋全幅移動術が奏効した動眼神経不全麻痺の1例

Full-width transposition of vertical muscles was effective in a case of oculomotor paresis

要約　背景：上下直筋の全幅移植術は，通常は高度な外転神経麻痺に対して行われる。目的：上下直筋の全幅移植術が，動眼神経不全麻痺で生じた内直筋麻痺に奏効した症例の報告。症例：31歳女性が6年前からの左眼の内転障害で受診した。3年前に左眼外直筋の10mm後転術を受けている。視力は両眼とも良好で，左眼に中等度の散瞳，内転制限，85Δの外斜視があった。上下直筋の全幅移動術を行い，筋腹を鼻側に移動させた。眼位は25Δに改善した。結論：上下直筋の全幅移植術が，動眼神経不全麻痺で生じた高度な内直筋麻痺に奏効した。

Abstract.　Background：Transposition of full-width bellies of vertical muscles is usually indicated for severe abducens palsy. Purpose：To report a case of oculomotor paresis with paralysis of inner rectus muscle treated by transposition of full-width bellies of vertical muscles. Case：A 31-year-old female sought medical advice for impaired adduction of her left eye of 6 years' duration. She had received 10mm recession of lateral rectus muscle 3 years before. Findings：Visual acuity was good in either eye. The left eye showed mydriasis,restriction of adduction,and exotropia by 85Δ. The left eye was treated by full-width transposition of vertical muscles towards the nasal direction. The eye position improved to exotropia by 25Δ. Conclusion：This case illustrates that transposition of full-width bellies of vertical muscles may be effective for paralysis of inner rectus muscle as manifestation of oculomotor paresis.