FULL FUNCTIONAL RECOVERY AFTER SURGICAL REPAIR OF TRANSECTED ABDUCENSNERVE - CASE-REPORT

OBJECTIVE AND IMPORTANCE: Results of surgical repair of the injured ab ducens nerve are rarely reported in the literature. A full functional recovery of a completely resected abducens root may be exceptional. We describe a patient who obtained normal ocular alignment and binocular vision after surgical reconstruction of a transected abducens nerve. CLINICAL PRESENTATION: A 56-year-old woman with a petroclival meningio ma was presented. She underwent total removal of the tumor through a c ombined supra/infratentorial transpetrosal approach. The abducens nerv e was tightly attenuated by the tumor and thickened dura. During disse ction, the nerve was completely transected just behind the entrance to Dorello's canal. INTERVENTION: The abducens nerve was the single root type and inevitably required surgical repair. To obtain a sufficient length of the distal stump for trimming, part of the petrosphenoidal l igament was cut and the superior border of the petrous bone was expose d. The proximal stump of the nerve was also trimmed to obtain healthy tissue, and reconstruction was performed with five 10-0 nylon sutures, Five months later, esodeviation began to improve. Nine months after t he surgery, the patient did not complain of diplopia and an objective assessment reported normal ocular alignment and estimated binocular fu nction as ''excellent'' according to Biglan's system. Overcorrection o f abduction did not occur. CONCLUSION: The result in our patient confi rms the possibility of full functional recovery after surgical repair of a totally transected abducens nerve.