Lee Justin J, Patil Nikhil, Schimmel Trent, Benson Matthew D, DeSerres Joshua J
Division of Plastic Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.
Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, AB, Canada.
Plast Surg (Oakv). 2025 Aug 29:22925503251371048. doi: 10.1177/22925503251371048.
Surgical repair of orbital fractures comes with risks. One rare risk is interference with the actions of the superior oblique tendon-muscle complex causing an acquired Brown syndrome. We present the case of a 45-year-old man who developed acquired Brown syndrome after undergoing repair of a large orbital floor and medial orbital wall fracture using a titanium mesh implant. A case report was prepared to discuss a rare surgical risk with open reduction internal fixation (ORIF) of an orbital wall fracture. A retrospective chart review was performed. Post-operative ophthalmological assessment revealed persistent diplopia along with limitations of up-gaze particularly in the adducted position. Ultimately, the patient underwent surgical repositioning of the orbital implant, which seemingly released the superior oblique muscle-tendon complex, resolving most of the diplopia. No further treatment with prisms or strabismus surgery has been required. Acquired Brown syndrome is a potential risk of surgical repair of orbital fractures involving the medial orbital wall. Herein this case study, we describe a case of acquired Brown syndrome following ORIF of an orbital floor and medial wall fracture, which was alleviated with a revision surgery.
眼眶骨折的手术修复存在风险。一种罕见的风险是干扰上斜肌腱-肌肉复合体的活动，从而导致获得性布朗综合征。我们报告一例45岁男性病例，该患者在使用钛网植入物修复大型眶底和眶内侧壁骨折后出现了获得性布朗综合征。编写了一份病例报告，以讨论眶壁骨折切开复位内固定术（ORIF）的一种罕见手术风险。进行了回顾性病历审查。术后眼科评估显示持续复视，伴有上视受限，尤其是在内收位时。最终，患者接受了眼眶植入物的手术复位，这似乎松解了上斜肌腱复合体，大部分复视得以解决。无需进一步进行棱镜治疗或斜视手术。获得性布朗综合征是涉及眶内侧壁的眼眶骨折手术修复的潜在风险。在本病例研究中，我们描述了一例眶底和眶内侧壁骨折切开复位内固定术后发生的获得性布朗综合征，该综合征通过翻修手术得到缓解。
