title: [Bilateral modified Hummelsheim procedure in severe bilateral abduction deficiency].
abstract: BACKGROUND
  Bilateral sixth nerve paralysis is a rare motility disturbance. The functional and cosmetic problems, operative management and postoperative outcome in three patients are presented.
  
  
  METHODS
  We report on the pre- and postoperative findings of three patients who in one operative session received bilateral transposition surgery in modification of the Hummelsheim procedure.
  
  
  RESULTS
  All three patients postoperatively showed good cosmetic results with no significant head posture for far and near fixation. The abduction deficiency was reduced. In one case a field of binocular single vision at far fixation was established. This field was positioned centrally and measured 15 degrees in diameter. No intraoperative or postoperative complications occurred.
  
  
  CONCLUSIONS
  Simultaneous bilateral transposition surgery as a modified Hummelsheim procedure can reduce head turn in patients with severe bilateral abduction deficiencies and may reestablish limited binocular single vision. In regard to their psycho-social interactions, the patients benefit from the diminished angle of squint.
authors.affiliation: Zentrum für Augenheilkunde, Universität Köln, Schielbehandlung und Neuroophthalmologie. Julia.Fricke@medizin.uni-koeln.de
authors.forename: J
authors.initials: J
authors.lastname: Fricke
authors.forename: A
authors.initials: A
authors.lastname: Neugebauer
mesh_terms: D020434:Abducens Nerve Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D003290:Convergence, Ocular; D004215:Distance Perception; D004948:Esotropia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D005403:Fixation, Ocular; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000294:innervation / Q000601:surgery*; D012189:Retrospective Studies; D014787:Vision Tests; D015348:Vision, Binocular