Extraorbital use of a disinserted superior oblique as a sling in third nerve palsy: a new single-stage surgical...

The management of third cranial nerve palsy is surgical. The usual technique is to correct alignment of the eyes in the first stage, followed by ptosis correction by a sling operation in the second stage. A new single-stage surgical technique involved the disinsertion of superior oblique muscle to bring the eye in a midline position. Simultaneously it is used extraorbitally as a sling to raise the ptotic upper eyelid. Postoperatively a fairly good cosmetic effect was achieved, but the upper eyelid showed a paradoxic aberrant elevation on eso-depression.