Superior Oblique Tenosynovial Syndrome Surgery

The superior oblique tendon sheath syndrome is also known as Brown syndrome. It is a congenital anatomic abnormality or excessive thickening or adhesion of the superior oblique muscle tendon and sheath caused by trauma or surgery, which limits the upward movement of the inferior oblique muscle, causing the eyeball to slant and the inner rotation position. The slant is more obvious. EMG examination of the lower oblique muscle function is normal, SEM examination of the affected intraocular position of the upward scanning speed slowed down, the pull test is limited to the internal transfer position. Previously, the superior oblique tendon sheath and tendon stripping have been used, and the early effect is good, but it is easy to relapse to form a new adhesion. At present, it is recommended to do the upper oblique muscle stenosis and the superior oblique muscle suspension. Treatment of diseases: superior oblique tendon sheath syndrome Indication Upper oblique tendon sheath surgery is applicable to: The first eye position of Brown syndrome is oblique, the compensatory head position is obvious, the traction test is positive or the squint movement speed is abnormal. Contraindications The first eye position is a positive position, and the pull test is negative or the speed of the saccade is not abnormal. Surgical procedure 1. Complete orthopedic surgery of the superior oblique muscle or partial excision of the superior oblique muscle (method "see upper oblique muscle tendon cutting"). If secondary superior oblique palsy occurs after upper oblique muscle stenosis, partial ipsilateral inferior oblique muscle resection or contralateral oblique muscle migration may be performed. 2. The superior oblique muscle suspension after the migration (method see "upper oblique muscle suspension after migration").

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