Superior oblique tenectomy in Brown's syndrome

Since its description in 1950, numerous surgical techniques have been advocated to treat Brown's superior oblique tendon sheath syndrome. Of these, a tenectomy of the homolateral superior oblique has emerged as the most effective method. However, an iatrogenically produced superior oblique paralysis has been found to be a frequent complication of this procedure. Of 12 patients with Brown's syndrome treated with a superior oblique tenectomy, this problem was encountered in eight patients, and additional surgery became necessary in each instance. The clinical management of such patients presents special problems and their solution will be illustrated by two case reports.