提上睑肌腱膜瓣联合额肌瓣悬吊治疗先天性上睑下垂畸形

Frontalis connected with levator palpebrae superior aponeurosis flap to correct severe congenital blepharoptosis

目的:研究改良的提上睑肌腱膜瓣联合额肌悬吊治疗重度先天性上睑下垂的临床治疗效果。方法:自2005年8月～2008年3月,笔者采用该方法矫治重度先天性上睑下垂患者20例,年龄6～27岁,单侧8例,双侧12例。手术形成蒂在睑板上缘的的提上睑肌腱膜瓣,并与额肌建立连接,模拟提上睑肌上提眼睑的功能。结果:本组患者20名,术后随访6个月,15例矫正效果良好,4例好转,1例无效,部分患者出现不同程度的眼睑闭合不全,术后2～3月恢复。无明显并发症发生,效果良好。结论:与单纯的额肌悬吊不同,该术式形成的上提眼睑系统更符合生理结构,并且具备动态矫正效果,手术后外形满意、功能良好。

Objective To explore the clinical curative effect to correct severe congenital blepharoptosis by connecting frontalis with levator palpebrae superior. Methods From August 2005 to May 2008, 20 patients（aged from 6 to 27 years） with severe congenital blepharoptosis had undergone the corrective surgery in our hospital. Among them, 8 patients with blepharoptosis were unilateral and the others were double. In the surgery, a levator palpebrae superior aponeurosis flap was formed and sutured with the frontalis to construct the connection of them. Results The curative effect had been evaluated 6 months later. Blepharoptosis of 15 patients were conspicuous corrected. Blepharoptosis of 4 patients were improved. 1 patient was undercorrection. The hypophasis appeared post-operation in most of patients, but they were rehabilitated after 2-3 months. No visible complications were occurred. Conclusion This method is designed according to the physiological functions and anatomic structure of eyelid, and the method can rehabilitated the dynamic effect of eyelid. The functions are satisfied after the surgery.