提上睑肌离断额肌瓣悬吊术治疗中重度Marcus-Gunn综合征的临床研究

Clinical study on the management of moderate to severe Marcus-Gunn jaw-winking syndrome with levator disinsertion and frontalis suspension

目的研究提上睑肌离断额肌瓣悬吊术治疗中重度Marcus-Gunn综合征的临床疗效。方法6例中重度Marcus-Gunn综合征患者采用提上睑肌离断额肌瓣悬吊手术治疗。结果随访6个月～5年,6例患者术后颌动瞬目症状消除,双侧睑裂对称,上睑缘无遮盖瞳孔,睑缘弧度自然美观,2例伴有轻度的上下睑闭合困难及上睑迟滞现象。结论提上睑肌离断额肌瓣悬吊术是治疗中重度Marcus-gunn综合征较理想的手术方法。

Objective To study the clinical effect of the management of moderate to severe Marcus-Gunn jaw-winking syndrome with levator disinsertion and frontalis suspension. Methods Six cases with moderate to severe Marcus-Gunn jaw-winking syndrome underwent levator disinsertion and frontalis suspension. Results Postoperative follow-up periods ranged from 6 to 60 months. All of the eyelids showed complete elimination of jaw winking, equal palpebral apertures and symmetrical contour. The upper palpebral margin was situated above the upper margin of the pupil when patients fixated naturally. Two cases were observed with slight lagophthalmos and hysteresis. Conclusion Levator excision and frontalis suspension is a feasible surgical approach in the management of moderate to severe Marcus Gunn jaw-winking syndrome.