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Comparison between Hummelsheim and Jensen procedures in the management of chronic sixth nerve palsy

  • Pediatrics
  • Published:
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Abstract

Purpose

To compare the postoperative alignment, degree of improvement of abduction, and complications of the Hummelsheim procedure to the Jensen procedure in chronic sixth nerve palsy, and to calculate the dose-response of both procedures.

Methods

A retrospective study was done on patients who either had Hummelsheim or Jensen procedure for chronic sixth nerve palsy. Demographic characteristics, details of surgical procedure, ductions, versions, and angles of misalignment before and after surgery were analyzed.

Results

A total of 79 patients were identified: 38 Jensen and 41 Hummelsheim. There were no statistically significant differences in baseline characteristics of both groups. Medial rectus recession was performed in 35 patients in the Jensen group and in 30 patients in the Hummelsheim group. Success defined as orthotropia within 8 PD was achieved in 25 (66%) patients in the Jensen group and in 24 (59%) patients in the Hummelsheim group (P = 0.51). The mean improvement in the angle of deviation in the primary position was 42 ± 12 PD in the Jensen group and 42 ± 16 PD in the Hummelsheim group (P = 0.89). The mean improvement in abduction was slightly better in the Hummelsheim group (1.8 vs 1.5, P = 0.32). A new vertical deviation occurred in three patients in the Jensen group and in 4 patients in the Hummelsheim group. Anterior segment ischemia occurred in one patient in the Jensen group.

Conclusions

There was no difference in the success rate between the Hummelsheim and Jensen procedures in cases of chronic sixth nerve palsy. Strabismus surgeons can choose between the two procedures according to their preference.

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Data availability

Full data are available from the corresponding author upon request.

Code availability

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Funding

The authors did not receive support from any organization for the submitted work.

Author information

Authors and Affiliations

  1. Ophthalmology Department, Faculty of Medicine, Cairo University, 7308 Street 83, Mokattam, Cairo, 11571, Egypt

    Shaimaa Arfeen & Ahmed Awadein

  2. Memorial Institute of Ophthalmic Research, Giza, Egypt

    Mostafa Azzab & Zeinab Saad

  3. Faculty of Medicine, Mansoura Ophthalmic Center, Mansoura University, Mansoura, Egypt

    Manal Kasem

  4. Ophthalmology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Amr Elkamshoushy

Authors
  1. Shaimaa Arfeen
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  2. Mostafa Azzab
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  3. Zeinab Saad
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  4. Ahmed Awadein
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  5. Manal Kasem
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  6. Amr Elkamshoushy
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Contributions

SA analyzed the data, did the statistical analysis, and wrote the manuscript. MA performed the literature review, tabulated the data, and drafted the manuscript. ZA contributed to the collection of the clinical data. AA contributed to the study design, cleaned and analyzed the data, did the statistical analysis, performed the surgeries, and revised the paper. He is the guarantor. MK and AE performed the surgeries, contributed to data collection, and revised the manuscript.

Corresponding author

Correspondence to Shaimaa Arfeen.

Ethics declarations

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee (Cairo University, Alexandria University, and Mansoura University Research Ethics Committee) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent to participate

Informed consent was obtained from the participants or the guardians of all individual participants included in the study.

Consent for publication

Additional informed consent was obtained from the participants or the guardians of all individual participants for whom identifying information is included in this article.

Conflict of interest

The authors declare no competing interests.

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Supplementary Information

Below is the link to the electronic supplementary material.

E-Supplement 1

Summary of the data of the patients in the Jensen Group (PDF 32 kb)

E-Supplement 2

Summary of the data of the patients in the Hummelsheim Group (PDF 34 kb)

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Arfeen, S., Azzab, M., Saad, Z. et al. Comparison between Hummelsheim and Jensen procedures in the management of chronic sixth nerve palsy. Graefes Arch Clin Exp Ophthalmol 260, 363–369 (2022). https://doi.org/10.1007/s00417-021-05352-4

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  • DOI: https://doi.org/10.1007/s00417-021-05352-4

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