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From: Adjustable Nasal Transposition of Split Lateral Rectus Muscle for Third Nerve Palsy
JAMA Ophthalmol. 2014;132(8):963-969. doi:10.1001/jamaophthalmol.2014.756
Figure Legend:
Schematic Interpretation of Nasal Transposition of the Split Lateral Rectus (LR) MuscleA, Anterior view, left eye. Left panel shows
passage of Gass muscle hook after LR muscle has been detached and split; right panel shows position of upper and lower muscle
halves adjacent to medial rectus (MR) insertion. B, Superior and inferior views of the left eye after transposition is complete. The
superior view demonstrates the course of the LR muscle under the superior oblique tendon; the inferior view shows the course
behind the inferior oblique muscle. The presumed
orbital pulley
theMedical
LR muscle forward before it courses behind the globe. IO
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© 2014directs
American
Date
of download:
4/29/2017
indicates
inferior oblique
muscle; IR, inferior rectusAssociation.
muscle; SO,
superior
oblique
All rights reserved. muscle; and SR, superior rectus muscle.
From: Adjustable Nasal Transposition of Split Lateral Rectus Muscle for Third Nerve Palsy
JAMA Ophthalmol. 2014;132(8):963-969. doi:10.1001/jamaophthalmol.2014.756
Figure Legend:
Successful Treatment of a 7-Month-Old Boy (Case 2) With Bilateral Third Nerve PalsiesA, Preoperative clinical image (following
ptosis repair). B, Postoperative clinical image 13 months after bilateral nasal transposition of the split lateral rectus (LR) muscle,
which is maintained at 20 months postoperatively. C and D, Preoperative axial T2 turbo spin echo image shows the normal position
of the LR muscle (C) and the postoperative, bilateral split of the LR muscle (arrowheads) posterior to the globe (D). E, Preoperative
coronal T1 image at 3 months of age shows theCopyright
attenuation
of the
superior,
medial, and inferior rectus muscles (arrowheads in right
© 2014
American
Medical
Date
download:
4/29/2017
orbit,ofsimilar
appearance
in left orbit) and the normal
LR
muscle.
F,
Postoperative
Association. All rights reserved. coronal T1 image 15 months after surgery shows
splitting of the LR muscle posterior to the globe (arrowheads).
From: Adjustable Nasal Transposition of Split Lateral Rectus Muscle for Third Nerve Palsy
JAMA Ophthalmol. 2014;132(8):963-969. doi:10.1001/jamaophthalmol.2014.756
Figure Legend:
Box Plot Showing Reduction of the Horizontal Misalignment With SurgeryThe median horizontal misalignment is identified by the
line in the center of each box and the 25th and 75th percentiles are shown by the lower and upper extents of the boxes,
respectively. The whiskers show the extent of the data and the + indicates an outlier. Exotropia is defined as positive misalignment
on the ordinate while esotropia is defined as negative misalignment.
Date of download: 4/29/2017
Copyright © 2014 American Medical
Association. All rights reserved.
From: Adjustable Nasal Transposition of Split Lateral Rectus Muscle for Third Nerve Palsy
JAMA Ophthalmol. 2014;132(8):963-969. doi:10.1001/jamaophthalmol.2014.756
Figure Legend:
Anterior Location of the Split in the Lateral Rectus (LR) Muscle in (A) Unsuccessful (Case 6) vs (B) Successful (Case 2) CasesA,
Axial T1 magnetic resonance image shows the LR muscle coursing slightly nasally but into the posterior sclera in the upper panel.
Axial T1 image with fat suppression shows the LR muscle split juxtaposed to the posterior sclera with a broad adherence to the
globe in this location in the lower panel. This image was obtained 5 months postoperatively. B, Axial T1 magnetic resonance image
shows the split in the LR muscle occurring posterior
to the©sclera
bilaterallyMedical
(arrowheads). In comparison with part A, the split of the
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2014 American
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LR muscle
is more4/29/2017
posterior in part B. This image Association.
was obtained
15
months
after
All rights reserved. surgery.