Superior oblique sharpening surgery in the treatment of Brown syndrome plus

Abstract

PurposeTo describe superior oblique sharpening in congenital Brown syndrome plus. Material and methodsA retrospective study of 17 Brown syndrome cases that were treated with oblique superior sharpening from 1997 to 2007. Vertical deviation in primary position was classified as + to +++, head tilt as: mild (< 10°), moderate (10–20°) and severe (≥ 20°); elevation in adduction from −1 to −4. A good postoperative result was considered if last elevation limitation in adduction was zero or −1, without head tilt and vertical deviation in primary position. ResultsMean age was 4.9 years. Limitation elevation in adduction which was −3 in 8 cases (47.1%) and −4 in 9 (52.9%), which improved completely after surgery in 6, −1 in 9 and −3 in 2 patients. Preoperative hypotropia in 15 cases (13 mild, 1 moderate and one severe) was resolved in 13 after surgery. Of 14 patients with torticollis (3 mild, 10 moderate and one severe) it was surgically corrected in 11. Success was achieved in 14 (82.4%), 2 were under corrected (11.8%) and one was overcorrected (5.88%). Mean follow-up was 60.71 months. ConclusionsOblique superior sharpening as treatment for Brown syndrome plus is an effective procedure. The incidence of secondary oblique palsies has been very low.