Brown Syndrome: Features And Long Term Results Of Management

Abstract

Brown's syndrome is a form of restrictive strabismus first described by Brown in 1905. It is characterized by a restriction of the superior oblique trochlea-tendon complex and patients have limited elevation in adduction that can be detected clinically as compensatory head posture. This syndrome may present in congenital, acquired, constant, or intermittent forms (1). Surgery is frequently indicated in the presence of strabismus or abnormal head position with Brown's syndrome (2). The surgical procedure used to address Brown's syndrome is based on the tight or stiff supe-rior oblique muscle (SOM)-tendon complex (3). Tenotomy and tenectomy are the most popular surgical treatments for Brown's syndrome.The aim of this study is to determine the demographic characteristics of 190 patients who were diagnosed with Brown syndrome, also describe surgical preferences and the long-term outcomes of surgery in Brown's syndrome. MethodsThis study retrospectively analyzed the medical charts of 190 patients that had been followed for Brown's syndrome and Objectives: The goal of this study was to evaluate surgical techniques and outcomes in patients with Brown's syndrome. Methods: A retrospective review was conducted of patients who underwent surgery of the superior oblique (SO) muscle between 2003 and 2011 at a referral center. Results: In all, 190 patients (111 female and 79 male) with an age range of 4-50 years were included in the study. The right eye was affected in 98 patients, and the left eye in 92 patients. Abnormal head posture (AHP), ocular movement (OM), and hypotropia were assessed. The greatest improvement of AHP was seen following an SO temporal tenotomy (91%). Patients with a -4 limitation achieved full OM after a SO temporal tenotomy. Conclusion: Temporal tenotomy provided the best improvement in limitation of elevation in adduction.