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上斜肌分离肌腱延长术治疗 Brown 综合征:长期疗效。

Superior oblique split tendon elongation for Brown's syndrome: Long-term outcomes.

机构信息

Department of Ophthalmology, Shamir Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Eur J Ophthalmol. 2021 Nov;31(6):3332-3336. doi: 10.1177/1120672121991050. Epub 2021 Mar 8.

Abstract

PURPOSE

To report the outcomes of superior oblique split tendon elongation in Brown's syndrome.

METHODS

Charts of 17 consecutive Brown's syndrome patients who underwent superior oblique split tendon elongation were reviewed and clinical data regarding preoperative, intraoperative, and postoperative data were collected.

RESULTS

About 17 eyes of 17 children with congenital Brown's syndrome underwent superior oblique split tendon elongation between January 2012 and March 2020 by a single surgeon. Mean age at surgery was 5.47 ± 2.82 (range 1.50-13.2). Eight (47.1%) were female. Preoperative deficit of elevation in adduction was -4 in all children. At the end of surgery, all eyes were freely elevated on adduction, on forced duction test. Mean follow-up time of 26.24 ± 11.22 (range 11-53) months. In 15 of 17 children (88.2%), motility improved, orthotropia in primary position was achieved, and head posture eliminated ( < 0.001). Superior oblique palsy occurred in two children, who after reoperation, achieved an acceptable outcome. No intraoperative complications were recorded.

CONCLUSION

The superior oblique split tendon elongation procedure is a useful surgical technique with stable and satisfying outcomes for the treatment of severe congenital Brown's syndrome.

摘要

目的

报告 Brown 综合征中对上斜肌腱延长术的结果。

方法

回顾了 17 例连续的 Brown 综合征患者的病历,收集了术前、术中及术后的临床数据。

结果

2012 年 1 月至 2020 年 3 月,由一位医生为 17 例儿童先天性 Brown 综合征患者实施了上斜肌腱延长术,共涉及 17 只眼。手术时的平均年龄为 5.47±2.82 岁(范围 1.50-13.2 岁)。女性 8 例(47.1%)。所有患儿的内收时上举缺陷术前均为-4。在手术结束时,所有的眼睛在强制内收试验中都可以自由上举。平均随访时间为 26.24±11.22 个月(范围 11-53 个月)。在 17 例儿童中(88.2%),15 例的眼球运动得到改善,正位眼位无偏斜,头位改善( < 0.001)。2 例患儿发生上斜肌麻痹,经再次手术后,获得了可接受的结果。未记录到术中并发症。

结论

上斜肌腱延长术是一种有效的手术技术,对于治疗严重的先天性 Brown 综合征,其结果稳定且令人满意。

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