应用改良的额肌瓣转移矫正重度上睑下垂

Modified treatment of moderate and severe Blepharoptosis with the suspension of Frontal muscle flap

目的:探讨应用改良的额肌瓣转移治疗重度上睑下垂的手术方法及临床价值。方法:沿重睑线切开皮肤,剪除部分眼轮匝肌,显露睑板;作皮下和额肌及额肌与骨膜间分离,于额肌与眼轮匝肌交界处提起并横行切断额肌,与其内侧斜向内上方弧形切开肌瓣达眉上1.5cm,外侧向外上方斜形剪开,注意不要超出眉毛平面0.5cm,形成不等边、扇形的额肌瓣,分别以内、中、外3点与睑板上缘作褥式缝合固定。结果:本组22例,切口均一期愈合,其中16例获得随访,上睑上提功能良好,重睑线自然、对称,“兔眼”征轻微,效果满意。结论:此法对额肌损伤小,不等边、呈扇形的额肌瓣使肌肉蒂部增宽,增加了额肌瓣的收缩力,适用于重度上睑下垂。

Objective To explore the operative methods and clinical effect of modified suspension of frontal muscle flap for moderate and severe blepharoptosis. Methods Dual eyelid line was designed according to the rule of dual eyelid plastic opertation. The skin and partly orbicularis oculi were incised, then tarsal plate was been revealed.The tunnel between orbicularis oculi and orbit septum was made, a inequilateral and flabelliform frontal muscle was designed in supraorbital margin frontal muscle attachment. Frontal muscle flap was sewn to the upper edge of tarsal plate. Results 52 cases of blepharoptosis had been treated,and 36case was follow-up. The upper eyelid was been good raising and the appearance of dual eyelid was natural and pretty. Conclusion This therapeutic method can reduce the damage of outer blood vessel and nerves of the frontal muscle flap, inequilateral and flabelliform frontal muscle flap improving the contractility is suitable to the therapy of moderate and severe blepharoptosis.