title: Management of superior oblique palsy after surgery for true Brown's syndrome.
abstract: Thirty patients requiring surgery for true Brown's syndrome were examined postoperatively. Follow-up ranged from three months to 20 years. Eight-five percent of patients demonstrated some degree of superior oblique palsy, with 54% having a decompensated condition and 30% requiring a second surgical procedure. Patients with marked preoperative restriction appear to be at increased risk for developing a decompensated superior oblique palsy postoperatively. Solutions to this problem are suggested: 1) perform tenotomy at insertion and preserve the adjacent intermuscular septum so a less crippling effect is seen; 2) combine tenotomy with inferior oblique weakening initially in those patients with marked preoperative restriction.
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles; D009886:Ophthalmoplegia / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D013285:Strabismus / Q000601:surgery*; D013577:Syndrome; D013710:Tendons / Q000601:surgery