Short communication
Nishida procedure associated with botulinum toxin in a long-standing complete bilateral sixth cranial nerve palsy
Procedimiento de Nishida asociado a toxina botulínica en parálisis completa del sexto par craneal bilateral de larga evolución
L. Mata Moret
, R. Freiria Barreiro, E. Cervera Taulet, C. Monferrer Adsuara, M. Ortiz Salvador, P. Palomares Fort
Corresponding author
Consorcio Hospital General Universitario de Valencia, Valencia, Spain
Read
7
Timeswas read the article
3
Total PDF
4
Total HTML
Share statistics
array:24 [ "pii" => "S217357941930132X" "issn" => "21735794" "doi" => "10.1016/j.oftale.2019.05.010" "estado" => "S300" "fechaPublicacion" => "2019-10-01" "aid" => "1530" "copyright" => "Sociedad Española de Oftalmología" "copyrightAnyo" => "2019" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2019;94:500-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2 "formatos" => array:2 [ "HTML" => 1 "PDF" => 1 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0365669119301819" "issn" => "03656691" "doi" => "10.1016/j.oftal.2019.05.012" "estado" => "S300" "fechaPublicacion" => "2019-10-01" "aid" => "1530" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2019;94:500-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 47 "formatos" => array:2 [ "HTML" => 32 "PDF" => 15 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Comunicación corta</span>" "titulo" => "Procedimiento de Nishida asociado a toxina botulínica en parálisis completa del sexto par craneal bilateral de larga evolución" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "500" "paginaFinal" => "503" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Nishida procedure associated with botulinum toxin in a long-standing complete bilateral sixth cranial nerve palsy" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figura 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1049 "Ancho" => 1305 "Tamanyo" => 137774 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A. Muestra el postoperatorio a las 24<span class="elsevierStyleHsp" style=""></span>h. B. Postoperatorio a los 30 días. C. Nueve posiciones diagnósticas de la mirada a los 6 meses. D. Seguimiento a los 12 meses.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L. Mata Moret, R. Freiria Barreiro, E. Cervera Taulet, C. Monferrer Adsuara, M. Ortiz Salvador, P. Palomares Fort" "autores" => array:6 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Mata Moret" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Freiria Barreiro" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Cervera Taulet" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Monferrer Adsuara" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Ortiz Salvador" ] 5 => array:2 [ "nombre" => "P." "apellidos" => "Palomares Fort" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S217357941930132X" "doi" => "10.1016/j.oftale.2019.05.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357941930132X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669119301819?idApp=UINPBA00004N" "url" => "/03656691/0000009400000010/v2_202112310746/S0365669119301819/v2_202112310746/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173579419301215" "issn" => "21735794" "doi" => "10.1016/j.oftale.2019.05.007" "estado" => "S300" "fechaPublicacion" => "2019-10-01" "aid" => "1521" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2019;94:504-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Amniotic membrane in the surgical treatment of post-blepharoplasty diplopia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "504" "paginaFinal" => "509" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Membrana amniótica en el tratamiento quirúrgico de diplopía posblefaroplastia" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2198 "Ancho" => 2928 "Tamanyo" => 386753 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sagittal section of eyelid, ocular globe and inferior and anterior region of the orbit, showing the proximity of the medial fat package with the inferior oblique, inferior rectus muscles and the Lockwood ligament. Original illustration by Dr. Héctor Fernández Jiménez-Ortiz.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "H. Fernández Jiménez-Ortiz, R. Gómez de Liaño Sánchez, S. Navas Pérez, I. Genol Saavedra, N. Toledano Fernández" "autores" => array:5 [ 0 => array:2 [ "nombre" => "H." "apellidos" => "Fernández Jiménez-Ortiz" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Gómez de Liaño Sánchez" ] 2 => array:2 [ "nombre" => "S." "apellidos" => "Navas Pérez" ] 3 => array:2 [ "nombre" => "I." "apellidos" => "Genol Saavedra" ] 4 => array:2 [ "nombre" => "N." "apellidos" => "Toledano Fernández" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669119301546" "doi" => "10.1016/j.oftal.2019.05.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669119301546?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579419301215?idApp=UINPBA00004N" "url" => "/21735794/0000009400000010/v1_201910010751/S2173579419301215/v1_201910010751/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173579419301355" "issn" => "21735794" "doi" => "10.1016/j.oftale.2019.05.011" "estado" => "S300" "fechaPublicacion" => "2019-10-01" "aid" => "1532" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2019;94:495-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Neuro-ophthalmological manifestations of POEMS syndrome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "495" "paginaFinal" => "499" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Manifestaciones neurooftalmológicas del síndrome de POEMS" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1785 "Ancho" => 2511 "Tamanyo" => 424270 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Compostite image of right eye (RE) and left eye (LE) at baseline assessment. (A) Color photograph showing optic disc edema. (B) Fluorescing angiography in late times showing optic disc staining due to edema. (C) Macular thickness map taken with OCT HD macular SD, showing thicknesses of 441<span class="elsevierStyleHsp" style=""></span>μm in RE and 405<span class="elsevierStyleHsp" style=""></span>um in LE. (D) OCT HD macular SD evidencing bilateral serous detachment of neuroepithelium at the subfoveal level, in addition to follow-up with color photograph and OCT HD macular SD post-treatment months 1 and 3, showing diminished optic disc edema and significant improvement of bilateral serous detachments at the foveal level.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Ortiz Zapata, P.L. Cárdenas, M.F. Acuña, M. Peralta Álvarez, J. Ortiz Zapata, B. Pizarro Imaicela" "autores" => array:6 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Ortiz Zapata" ] 1 => array:2 [ "nombre" => "P.L." "apellidos" => "Cárdenas" ] 2 => array:2 [ "nombre" => "M.F." "apellidos" => "Acuña" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Peralta Álvarez" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Ortiz Zapata" ] 5 => array:2 [ "nombre" => "B." "apellidos" => "Pizarro Imaicela" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669119301832" "doi" => "10.1016/j.oftal.2019.05.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669119301832?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579419301355?idApp=UINPBA00004N" "url" => "/21735794/0000009400000010/v1_201910010751/S2173579419301355/v1_201910010751/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Nishida procedure associated with botulinum toxin in a long-standing complete bilateral sixth cranial nerve palsy" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "500" "paginaFinal" => "503" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "L. Mata Moret, R. Freiria Barreiro, E. Cervera Taulet, C. Monferrer Adsuara, M. Ortiz Salvador, P. Palomares Fort" "autores" => array:6 [ 0 => array:4 [ "nombre" => "L." "apellidos" => "Mata Moret" "email" => array:1 [ 0 => "luciamatamoret@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Freiria Barreiro" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Cervera Taulet" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Monferrer Adsuara" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Ortiz Salvador" ] 5 => array:2 [ "nombre" => "P." "apellidos" => "Palomares Fort" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Consorcio Hospital General Universitario de Valencia, Valencia, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Procedimiento de Nishida asociado a toxina botulínica en parálisis completa del sexto par craneal bilateral de larga evolución" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1478 "Ancho" => 905 "Tamanyo" => 127643 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Large angle esotropia can be appreciated in both eyes with abduction limitation which did not reach the middle line in the RE and did not exceed it in the LE. Associated compensation torticollis.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Clinic case report</span><p id="par0005" class="elsevierStylePara elsevierViewall">Male, 39, who consulted for long-term bilateral 6th cranial nerve palsy. The patient had suffered a severe head injury in a traffic accident 15 years earlier that required decompressive craniotomy. Said bilateral 6th cranial nerve palsy was a sequel of the surgery. Due to the patient’s condition at the time he was not assessed or treated by an ophthalmologist.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient exhibited large angle esotropia in both eyes, with 4+ abduction limitation in the right eye (RE) that did not reach the middle line, and 3<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>ABD limitation in the left eye (LE) that did not exceed either the middle line. It proved impossible to assess the deviation angle with prism-cover due to the inability of taking the eye to the primary gaze position. Approximate measurement became necessary with the Hirschberg and Krimsky tests in the eye with the best duction (LE), evidencing a Krimsky test above 45 DP. The patient did not exhibit modifications in the near and far measurements. In addition, he exhibited a 20° compensatory torticollis towards the left, with the LE being dominant. He did not refer diplopia although the visual axis of the RE was compromised by said deviation. It was not possible to assess suppression at the time. (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Due to the patient history and the complexity of the case, i.e., a large angle deviation associated to severe motility restriction, it was decided to perform a retroinsertion of middle rectus (MR) of 11<span class="elsevierStyleHsp" style=""></span>mm in RE and 10<span class="elsevierStyleHsp" style=""></span>mm in LE, together with lateral rectus (LR) resection of 11<span class="elsevierStyleHsp" style=""></span>mm in RE and 10<span class="elsevierStyleHsp" style=""></span>mm in LE, adding vertical transposition according to the modified Nishida technique in both eyes as well as the injection of 10<span class="elsevierStyleHsp" style=""></span>UI botulinum toxin in the MR under the exposed muscle. Even though the measurement of the deviation angle was difficult in this case, it was decided to perform asymmetrical procedures due to the best duction in the LE of the patient. During surgery, the forced duction test confirmed a clear restrictive component (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">In the immediate postoperative, the patient exhibited slight adduction limitation in both eyes, slightly larger in the RE, as well as 15° exotropia in the RE with slight ptosis in the same eye, which can be explained due to the effect of the botulinum toxin, whereas the LE was adequately aligned in primary gaze position, with absence of torticollis and without diplopia at that time. The patient probably exhibited suppression, which facilitated diplopia in the immediate postop (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>a and b). Despite the slight exotropia secondary to the botox effect, the patient was able to fixate with both eyes despite LE dominance.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Six months after surgery (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>c), orthotopia in primary gaze position was found in an assessment, as well as recovery of 15° abduction without evident secondary verticalism, with slight adduction limitation.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Twelve months after surgery (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>d) satisfactory results subsisted, without diplopia in daily activity and excellent post-surgery recovery.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">The treatment of sixth cranial pair palsy is complex and varied, depending on the evolution time and the degree of deviation of patients. Before 12 months, early treatment can be performed with botulinum toxin with success rates of up to 47%.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> This treatment is recommendable for short-term palsy cases.</p><p id="par0040" class="elsevierStylePara elsevierViewall">In what concerns palsy that does not respond to conservative approaches, we have found several surgical techniques.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> For slight limitations it is recommendable to perform classic retroinsertion techniques which demonstrate satisfactory results in the long-term. As for moderate limitations, innervation or equalling techniques can be applied. However, in total limitations as in the present case it is necessary to apply a transposition technique, a highly aggressive surgery for patients.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Superior and inferior rectus transpositions have been described in numerous occasions by several authors including Hummelsheim, O’Connor, Jensen or Foster, with significant deviation improvements despite the variability of results.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–6</span></a> In 2003, for the first time Nishida described a transposition technique without deinsertion of the vertical rectus<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> due to one of the most feared complications in strabismus surgery, i.e., the anterior segment ischemia syndrome.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> This technique allows us to perform large transpositions with good postoperative results, therefore being considered as the technique of choice in complex 6th cranial pair palsy cases or in patients with vascular risk factors, in order to avoid the anterior segment ischemia syndrome.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Said technique has been described in the literature, reporting mostly positive results for 6th cranial pair palsy.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9,10</span></a> Said reports involved palsy cases with 18–20 months evolution from onset. The present case consisted in a long-term, bilateral and large angle 15-year palsy. Even so, the results were comparable to those reported in other publications. In addition, the present case exhibited good response to botulinum toxin therapy, although its use is not recommended in palsy cases exceeding 6 months of evolution.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflict of interests</span><p id="par0055" class="elsevierStylePara elsevierViewall">No conflict of interests was declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:3 [ "identificador" => "xres1250893" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1159780" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1250892" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1159781" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Clinic case report" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflict of interests" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-01-28" "fechaAceptado" => "2019-05-13" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1159780" "palabras" => array:4 [ 0 => "Sixth cranial nerve palsy" 1 => "Rectus transposition" 2 => "Anterior segment ischaemia syndrome" 3 => "Nishida procedure" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1159781" "palabras" => array:4 [ 0 => "Parálisis del sexto par craneal" 1 => "Transposición de rectos" 2 => "Síndrome de isquemia del segmento anterior" 3 => "Procedimiento de nishida" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In severe cases of abducens or sixth cranial nerve palsy, transpositions of the superior rectus and inferior rectus into the paralytic lateral rectus have been demonstrated to be useful. Numerous techniques have been described over time to carry out these transpositions, such as the Hummelscheim, O’connor, Jensen, Foster, or Nishida technique. The first 4 techniques mentioned above have an increased risk of anterior segment ischaemia.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The case is presented of a long-standing bilateral sixth cranial nerve palsy secondary to a severe cranial injury. Given the risk of ischaemia of the anterior segment, the Nishida technique was chosen in order to reduce the risk of suffering from this complication. This is combined with botulinum toxin in both middle rectus to try to resolve the muscle contracture associated with the long evolution of the case, obtaining good results at 6, and 12 months after the surgical procedure.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">En los casos severos de parálisis del abducens o sexto par craneal resultan útiles las transposiciones de rectos superiores (RS) y rectos inferiores (RI) hacia el recto lateral (RL) paralítico. Se han descrito numerosas técnicas a lo largo del tiempo para la realización de estas transposiciones como son la técnica de Hummelscheim, O’connor, Jensen, Foster o Nishida. Las 4 primeras técnicas anteriormente citadas, llevan aparejado un aumento del riesgo de isquemia del segmento anterior.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de una parálisis de sexto par craneal bilateral de larga data de evolución secundaria a un traumatismo craneo encefálico severo (TCE). Para minimizar el riesgo de isquemia del segmento anterior se optó por la realización de la técnica de Nishida, asociado a botox en ambos rectos medios (RM) para tratar de resolver la contractura muscular asociada a la larga evolución del caso, obteniendo buenos resultados a los 6, y 12 meses tras el procedimiento quirúrgico.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Mata Moret L, Freiria Barreiro R, Cervera Taulet E, Monferrer Adsuara C, Ortiz Salvador M, Palomares Fort P. Procedimiento de Nishida asociado a toxina botulínica en parálisis completa del sexto par craneal bilateral de larga evolución. Arch Soc Esp Oftalmol. 2019. <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.oftal.2019.05.012">https://doi.org/10.1016/j.oftal.2019.05.012</span></p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1478 "Ancho" => 905 "Tamanyo" => 127643 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Large angle esotropia can be appreciated in both eyes with abduction limitation which did not reach the middle line in the RE and did not exceed it in the LE. Associated compensation torticollis.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 869 "Ancho" => 1305 "Tamanyo" => 198385 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Schema of the surgical technique, showing 11<span class="elsevierStyleHsp" style=""></span>mm retroinsertion of middle rectus (MR) in RE and 10<span class="elsevierStyleHsp" style=""></span>mm in LE, together with 11<span class="elsevierStyleHsp" style=""></span>mm resection of lateral rectus in RE and 10<span class="elsevierStyleHsp" style=""></span>mm in LE. In addition, the vertical transposition can be seen, tying one third of the temporal part of the vertical rectus and fixing them in the temporal superior and inferior quadrant, respectively, at 10<span class="elsevierStyleHsp" style=""></span>mm of the limbus, as explained by the Nishida technique. Subsequently, 10<span class="elsevierStyleHsp" style=""></span>UI of botulinum toxin were injected in the MR of the RE below the exposed muscle.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1049 "Ancho" => 1305 "Tamanyo" => 138263 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) Postoperative 24<span class="elsevierStyleHsp" style=""></span>h after surgery. (B) Postop at 30 days. (C) Nine diagnostic gaze positions after 6 months. (D) follow-up at 12 months.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early and late botulinum toxin treatment of acute sixth nerve palsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.D. Murray" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Aust N Z J Ophthalmol" "fecha" => "1980" "volumen" => "17" "paginaInicial" => "239" "paginaFinal" => "245" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2803769" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Results of surgery for paralytic esotropia due to abducens palsy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Maruo" 1 => "H. Iwashige" 2 => "N. Kubota" 3 => "T. Ishida" 4 => "M. Honda" 5 => "T. Hayashi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Jpn J Ophthalmol" "fecha" => "1996" "volumen" => "40" "paginaInicial" => "229" "paginaFinal" => "234" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8876391" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A muscle transposition procedure for abducens palsy, in which the halves of the vertical rectus muscle bellies are sutured onto the sclera" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Nishida" 1 => "A. Inatomi" 2 => "Y. Aoki" 3 => "O. Hayashi" 4 => "T. Iwami" 5 => "S. Oda" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Jpn J Ophthalmol" "fecha" => "2003" "volumen" => "47" "paginaInicial" => "281" "paginaFinal" => "286" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12782165" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Weitere Erfahrungen mit partieller Sehnen-Überpflanzung an den Augenmuskeln" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E. Hummelsheim" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Augenheilkd" "fecha" => "1909" "volumen" => "62" "paginaInicial" => "71" "paginaFinal" => "74" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tendon transplantation in ocular muscle paralysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.J. O’Connor" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Ophthalmol" "fecha" => "1935" "volumen" => "18" "paginaInicial" => "813" "paginaFinal" => "820" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rectus muscle union: a new operation for paralysis of the rectus muscles" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C.D.F. Jensen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Trans Pac Coast Otoophthalmol Soc Annu Meet" "fecha" => "1964" "volumen" => "45" "paginaInicial" => "359" "paginaFinal" => "387" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14269936" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vertical muscle transposition augmented with lateral fixation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.S. Foster" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J AAPOS" "fecha" => "1997" "volumen" => "1" "paginaInicial" => "20" "paginaFinal" => "30" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10530981" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anterior segment ischemia following strabismus surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.W. Simon" 1 => "E.C. Price" 2 => "G.B. Krohel" 3 => "R.W. Poulin" 4 => "R.D. Reinecke" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Pediatr Ophthalmol Strabismus" "fecha" => "1984" "volumen" => "21" "paginaInicial" => "179" "paginaFinal" => "184" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6502407" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vertical rectus transpositions in sixth nerve palsies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K.B. Gunton" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/ICU.0000000000000178" "Revista" => array:6 [ "tituloSerie" => "Current Opinion in Ophthalmology" "fecha" => "2015" "volumen" => "26" "paginaInicial" => "366" "paginaFinal" => "370" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26247134" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcomes of three different vertical rectus muscle transposition procedures for complete abducens nerve palsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Del Pilar González" 1 => "S.P. Kraft" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaapos.2015.01.007" "Revista" => array:6 [ "tituloSerie" => "J AAPOS" "fecha" => "2015" "volumen" => "19" "paginaInicial" => "150" "paginaFinal" => "156" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25828817" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009400000010/v1_201910010751/S217357941930132X/v1_201910010751/en/main.assets" "Apartado" => array:4 [ "identificador" => "5812" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Short communications" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009400000010/v1_201910010751/S217357941930132X/v1_201910010751/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357941930132X?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2023 March | 3 | 2 | 5 |
| 2019 October | 1 | 1 | 2 |
