First intraoperative trochlea reconstruction

Abstract

Traumatic detachment of the superior oblique muscle from the trochlea is very rare. The authors present a case of cyclovertical diplopia in downgaze due to traumatic trochlear damage where they performed surgery more than 40 years later. For the first time ever, they describe the reconstruction of the trochlea using a silicone tube, thereby regaining superior oblique muscle function.

The trochlea is a ligamentous structure that ensures correct functioning of the superior oblique muscle. Damage to the trochlea may involve the muscle itself and/or can compromise the path of the muscle through the orbit. Reconstruction of the trochlea itself and obtaining gain of superior oblique muscle function has never been described. We present a case where we successfully created a trochlea from a silicone tube, illustrating the benefit of a surgeon’s intraoperative creativity. This study adhered to the tenets of the Declaration of Helsinki and the authors declare no conflicts of interest.