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Diplopia due to skew deviation following neurotologic procedures
Maura K Cosetti1, Kareem Tawfik, Mohammad Fouladvand
1Department of Otolaryngology, New York University School of Medicine, New York, New York, USA.
Summary
Post-surgical skew deviation can cause diplopia after cerebellopontine angle (CPA) surgery or labyrinthectomy. Patients with preoperative hearing may be at higher risk, but symptoms often resolve within 10 weeks.
Area of Science:
- Ophthalmology
- Neurosurgery
- Vestibular Science
Background:
- Diplopia following cerebellopontine angle (CPA) surgery or labyrinthectomy is a recognized complication.
- Skew deviation, a vertical misalignment of the eyes, can manifest as diplopia.
Observation:
- This study retrospectively analyzed 4 patients who developed vertical diplopia due to skew deviation post-CPA surgery or labyrinthectomy.
- Neuro-ophthalmologic examinations, including head tilt testing, revealed hypertropia in all patients.
Findings:
- Skew deviation occurred immediately after surgical intervention in patients with preoperative residual hearing.
- Extraocular movements were intact, and the skew deviation resolved spontaneously within 10 weeks in all cases.
Implications:
- Acute vestibular deafferentation following CPA surgery or labyrinthectomy can lead to postoperative skew deviation and diplopia.
- Preoperative hearing may indicate residual vestibular function and identify patients at increased risk for this complication.
