Superior oblique tendon sheath syndrome: an unusual case

It is now recognized that the clinical findings of Brown's superior oblique tendon sheath syndrome can be caused by a variety of abnormalities. This has led to classification into "true" and "simulated" sheath syndromes. This report describes a case of simulated sheath syndrome caused by an anomalous fibrous band between the superior oblique tendon sheath and the upper nasal intermuscular quadrant. This unusual anomaly results in functional shortening of the sheath. Division of the band eliminated the restrictions on traction test and improved elevation in all fields postoperatively.