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Surgical results in Brown syndrome
D T Sprunger1, G K von Noorden, E M Helveston
1Cullen Eye Institute, Baylor College of Medicine, Houston, Tex.
Summary
Superior oblique tenectomy is the most effective initial surgery for Brown syndrome, successfully treating abnormal head posture. While surgery doesn't guarantee sensory improvement, it avoids worsening it.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Surgery
Background:
- Brown syndrome, previously known as Brown superior oblique tendon sheath syndrome, presents with abnormal head posture or hypotropia.
- Existing surgical treatments for Brown syndrome lack consensus, with variable outcomes and complications.
Purpose of the Study:
- To review surgical techniques and outcomes for Brown syndrome at two major institutions.
- To identify the most efficacious initial surgical procedure for managing Brown syndrome.
Main Methods:
- Retrospective chart review of 38 patients treated between 1965 and 1989.
- Analysis of surgical procedures, success rates, and complications for Brown syndrome.
Main Results:
- Superior oblique tenectomy was identified as the most effective initial surgical procedure.
- Surgery successfully treated anomalous head posture in Brown syndrome patients.
- No sensory function loss occurred post-surgery, though improvement was not guaranteed.
Conclusions:
- Superior oblique tenectomy is recommended as the primary surgical approach for Brown syndrome.
- Combined superior oblique weakening and iatrogenic palsy surgery is not advised initially due to potential for developing palsy.