Outcomes of Surgical and Non-Surgical Treatment for Sixth Nerve Palsy

Purpose: to report the outcomes of surgical and non-surgical treatment in sixthnerve paresis and palsy.methods: this retrospective study was performed on hospital records of 33 consecutivepatients (37 eyes) with sixth nerve dysfunction who were referred to labbafinejadmedical center from september 1996 to september 2006, and underwent surgicalprocedures or botulinum toxin injection. patients were divided into three groups:group a had muscle surgery without transposition, group b underwent transpositionprocedures and group c received botulinum toxin injection.results: overall, 33 patients including 19 male and 14 female subjects with meanage of 20.4±17.2 years (range, 6 months to 66 years) were studied. eye deviationimproved from 50.3±16.8 to 6.0±9.8 prism diopters (pd) after the first operationand to 2.5±5.0 pd after the second operation in group a, from 56.9±24.3 to 5.5±16.0pd after the first procedure and to almost zero following the second in group b,and from 44.3±10.5 to 15.0±20.0 pd 6 months following botulinum toxin injection ingroup c. head posture and limitation of motility also improved significantly in allthree groups. the overall rate of reoperations was 21%.conclusions: various procedures are effective for treatment of sixth nerve dysfunction;all improve ocular deviation, head turn and abduction deficit. the rate of reoperationis not high when treatment is appropriately selected according to clinical condition.