Siegel LM, DeSalles NL, Rosenbaum AL, Demer JL
Department of Ophthalmology, University of California, Jules Stein Eye Institute, Los Angeles, USA
Strabismus. 1998 Mar;6(1):19-29. doi: 10.1076/stra.6.1.19.672.
The action of the superior oblique muscle depends on both the contractile function of the muscle belly as well as the force transmission function of the tendon trochlea complex. Brown's syndrome is a restriction to elevation in adduction presumed due to an anomaly of the superior oblique tendon trochlea complex. This report presents two patients with an unusual restriction to elevation in adduction in the affected eye, and a clinical picture consistent with a Brown's syndrome. A non-invasive analysis of the functional anatomy of the superior oblique was performed using a high-resolution MRI with surface coils. Imaging in the first case revealed a cyst in the area of the right superior oblique tendon just posterior to the trochlea in primary position. The second patient had undergone reattachment of an avulsed trochlea after a dog bite (canine tooth syndrome). Imaging in the second case revealed scarring and connective tissue disruption around the tendon impeding muscle function. These findings provide distinct mechanical explanations for Brown's syndrome.
上斜肌的作用取决于肌腹的收缩功能以及肌腱滑车复合体的力传递功能。布朗综合征是一种内收时上抬受限的疾病，推测是由于上斜肌腱滑车复合体异常所致。本报告介绍了两名患眼内收时上抬出现异常受限且临床表现符合布朗综合征的患者。使用带有表面线圈的高分辨率磁共振成像对上斜肌的功能解剖进行了无创分析。第一例患者的成像显示，在原在位时，右侧上斜肌腱位于滑车后方区域有一个囊肿。第二例患者曾因犬咬伤（犬牙综合征）接受过撕脱滑车的重新附着手术。第二例患者的成像显示，肌腱周围有瘢痕形成和结缔组织破坏，妨碍了肌肉功能。这些发现为布朗综合征提供了独特的力学解释。
