Related Experiment Video
Updated: May 9, 2026
Optic Nerve Transection: A Model of Adult Neuron Apoptosis in the Central Nervous System
Published on: May 12, 2011
Persistent diplopia and superior oblique muscle dysfunction following dissection of the orbital periosteum in cranial
Hilary M Grabe1, Erin L McKean, Eric R Eggenberger
1Department of Ophthalmology and Visual Sciences, University of Michigan, , Ann Arbor, Michigan, USA.
Background/Aims:
Persistent diplopia secondary to a fourth cranial nerve palsy is poorly documented after open cranial base surgery.
Methods:
Six cases of fourth cranial nerve palsy after cranial base surgery were drawn from the Neuro-Ophthalmology and Head and Neck Surgery Clinics at the University of Michigan from 2004 to 2012.
Results:
Six patients developed diplopia and ocular misalignment in a pattern suggestive of superior oblique palsy following dissection of the medial orbital periosteum as part of a surgical approach to the anterior cranial base. Among the four patients in whom follow-up examination was available, the misalignment improved spontaneously in three patients and was stable in the fourth patient, but did not completely resolve in any patient.
Conclusions:
This sparsely documented phenomenon is likely caused by dysfunction of the superior oblique muscle, possibly the result of malposition of the trochlea after spontaneous reattachment of the periosteum. Special factors such as invasive tumours, repeated surgeries of this nature, prior radiation, or chemical cementing material that adversely affects wound healing may be contributory.
Related Concept Videos
01:17Accessory Structures of the Eye
01:20Muscles of the Eye
Extraocular Muscles
The six extraocular muscles surround the eyeball and control its movements. They are responsible for a wide range of eye motions, including looking up, down, left, right, and rotating...
01:14Cranial Nerves: Types Part I
Olfactory Nerve (Cranial Nerve I)
The olfactory nerve, or cranial nerve I, is unique as it is purely sensory and dedicated to the sense of smell. This nerve originates in the olfactory epithelium of the...
01:14Cranial Bones: Superior and Posterior View
The frontal bone is the single bone that forms the forehead. At its anterior midline, between the eyebrows, there is a slight depression called the glabella. The frontal bone also forms the supraorbital margin of the orbit. Near the middle of this margin is the supraorbital foramen, the opening that provides passage for a sensory nerve to the forehead. The frontal bone is thickened just above each supraorbital margin,...