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[Superior oblique sharpening in Brown's syndrome "plus". Results]
P Merino Sanz1, P Gómez de Liaño Sánchez, I Valls Ferrán
1Hospital General Universitario Gregorio Marañón, Madrid, España.
Purpose:
To study the results found in patients with congenital and constant Brown's Syndrome who were surgically treated with superior oblique sharpening technique.
Method:
Nine patients were selected among nineteen cases diagnosed of Brown's Syndrome in our Department for 4 years. Indications for surgery were vertical deviation in primary position and/or torticollis. The procedure of choice was the superior oblique sharpening in all cases, associated to its recession in 3 patients.
Results:
The limitation of elevation in adduction was notably marked in 100% of the cases, improving in all of them, except in one patient (11.1%) after surgery. The preoperative hypotropia presented in 7 cases (77.8%) was resolved in 5 (71.42%) after the intervention. The initial torticollis had the same incidence than the hypotropia (77.8%: 7/9), but it completely resolved in 3 cases, and improved in 3 other with this technique. Binocular vision was recovered in 2 patients. Overall, 2 out of the 9 cases (22.22%) did not clinically improve. Intraoperative and postoperative complications were not observed, except a temporary superior oblique palsy that resolved without surgery.
Conclusions:
The superior oblique sharpening is a good technique which may improve the Brown Syndrome patients with primary position deviation and/or torticollis.
