Superior oblique myectomy and trochlear resection for superior oblique myokymia.
OBJECTIVE
To describe our experience with myectomy of the superior oblique muscle combined with resection of the trochlea for recurrent or primary superior oblique myokymia (SOM).


METHODS
Retrospective, interventional case series.


METHODS
We performed superior oblique myectomy combined with resection of the trochlea in 3 patients with SOM in whom medical management had failed. In 2 patients, the symptoms of myokymia were recurrent after previous superior oblique tenectomy, and in 1 patient, our procedure was the first surgery.


RESULTS
All 3 patients have experienced complete symptomatic relief from SOM with follow-up ranging from 1 to 22 years. Iatrogenic superior oblique palsy has been managed in each patient. Dysesthesia in the infratrochlear and supratrochlear regions was judged by each patient to be much less bothersome than the symptoms of SOM.


CONCLUSIONS
We recommend myectomy of the superior oblique muscle combined with resection of the trochlea if symptoms of SOM recur after a prior superior oblique tenectomy. Based on this small series with long follow-up, the procedure also may be considered as the primary operation for SOM that fails medical management.
Ruttum
Mark S
MS
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA. mruttum@mcw.edu
Harris
Gerald J
GJ
D000328:Adult; D005133:Eye Movements / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015835:Ocular Motility Disorders / Q000503:physiopathology / Q000601:surgery*; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014321:Trochlear Nerve / Q000601:surgery*; D020432:Trochlear Nerve Diseases / Q000503:physiopathology / Q000601:surgery*