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

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.