{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T03:35:42Z","timestamp":1770348942883,"version":"3.49.0"},"reference-count":11,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,11,15]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>A male child presented with complex abnormal head posture (AHP), characterised by a 35\u00b0 left head turn and a 45\u00b0 left head tilt. Orthoptic evaluation revealed orthotropia with full ocular motility and a high-frequency, moderate-amplitude horizontal pendular nystagmus, which dampened in the preferred AHP. The remainder of ocular examination was unremarkable.<\/jats:p>\n                  <jats:p>Surgical correction was performed using Park\u2019s modification of the horizontal Kestenbaum procedure to shift both eyes to the left. To address the head tilt, extorsion of the left eye and intorsion of the right eye were achieved by vertically offsetting the horizontal rectus muscles.<\/jats:p>\n                  <jats:p>Postoperative evaluation showed complete resolution of the head turn, with a residual 5\u00b0 left head tilt, which remained stable at 1-year follow-up.<\/jats:p>\n                  <jats:p>In conclusion, this surgical approach offers a simple and effective method for simultaneous correction of head tilt and turn in idiopathic infantile nystagmus syndrome, reducing the need for more complex muscle surgery.<\/jats:p>","DOI":"10.1136\/bcr-2024-262056","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T13:55:35Z","timestamp":1770299735000},"page":"e262056","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Recession-resection combined with vertical offset of horizontal rectus muscles for management of combined head turn and head tilt in idiopathic infantile nystagmus syndrome"],"prefix":"10.1136","volume":"19","author":[{"given":"Mohamed F","family":"Farid","sequence":"first","affiliation":[{"name":"Ophthalmology, Swansea Bay University Health Board, Port Talbot, UK"},{"name":"Ophthalmology Department, Benha University Hospital, Benha, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"2026020505552574000_19.2.e262056.1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1080\/0065955X.1973.11982319","article-title":"Congenital Nystagmus Surgery","volume":"23","author":"Parks","year":"1973","journal-title":"Am orthopt j"},{"key":"2026020505552574000_19.2.e262056.2","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1097\/OPX.0000000000002131","article-title":"Infantile nystagmus syndrome: An observational, retrospective, multicenter study","volume":"101","author":"Fossataro","year":"2024","journal-title":"Optom Vis Sci"},{"key":"2026020505552574000_19.2.e262056.3","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.37.5.267"},{"key":"2026020505552574000_19.2.e262056.4","first-page":"599","article-title":"New operation for nystagmus","volume":"6","author":"Kestenbaum","year":"1953","journal-title":"Bull Soc Ophtalmol Fr"},{"key":"2026020505552574000_19.2.e262056.5","doi-asserted-by":"crossref","first-page":"3061","DOI":"10.4103\/ijo.IJO_358_22","article-title":"Vertical transposition of the horizontal rectus muscles to correct head tilt because of infantile nystagmus syndrome - A case series","volume":"70","author":"Kekunnaya","year":"2022","journal-title":"Indian J Ophthalmol"},{"key":"2026020505552574000_19.2.e262056.6","unstructured":"Conrad HG , Decker W . Torsional kestenbaum procedure: evolution of a surgical concept. In: Reinecke RD , ed. Strabismus II."},{"key":"2026020505552574000_19.2.e262056.7","first-page":"70","article-title":"Torsional Kestenbaum in congenital nystagmus with torticollis","volume":"38","author":"Prakash","year":"1990","journal-title":"Indian J Ophthalmol"},{"key":"2026020505552574000_19.2.e262056.8","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.jaapos.2012.05.005","article-title":"Oblique muscle surgery for treatment of nystagmus with head tilt","volume":"16","author":"Lueder","year":"2012","journal-title":"J AAPOS"},{"key":"2026020505552574000_19.2.e262056.9","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ajo.2020.04.034","article-title":"Horizontal Transposition of the Vertical Rectus Muscles to Correct a Head Tilt in 5 Patients With Idiopathic Nystagmus Syndrome","volume":"217","author":"de Castro-Abeger","year":"2020","journal-title":"Am J Ophthalmol"},{"key":"2026020505552574000_19.2.e262056.10","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/S0002-9394(14)72058-6","article-title":"Horizontal transposition of the vertical rectus muscles for cyclotropia","volume":"122","author":"von Noorden","year":"1996","journal-title":"Am J Ophthalmol"},{"key":"2026020505552574000_19.2.e262056.11","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1080\/09273972.2022.2097704","article-title":"Correction of horizontal and torsional compensatory head posture in infantile nystagmus syndrome using horizontal rectus muscle recession and resection with vertical transposition","volume":"30","author":"Baldev","year":"2022","journal-title":"Strabismus"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-262056","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T13:55:39Z","timestamp":1770299739000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-262056"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,5]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bcr-2024-262056"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-262056","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}