重睑联合内眦赘皮矫正术的解剖研究及临床应用

Anatomic study and clinical application of the epicanthoplasty combined with blepharoplasty

目的:以内眦部解剖学研究为基础,探讨由重睑入路矫正内眦赘皮在临床中的应用。方法:对9具头部标本内眦部进行解剖研究及组织学观察,临床采用重睑切口,广泛分离内眦部,打断你内眦韧带与皮肤间的纤维连接,去除部分错构的眼轮匝肌,重建内眦结构,间断缝合重睑切口。结果:内眦韧带前支与覆盖其上的皮肤之间有明显纤维连接,在部分样本中可以观察到眼轮匝肌有跨越内眦韧带的现象。本组共矫正内眦赘皮42例,随访1～6个月后,35例轻中度患者中31例得到明显改善,重度患者7例,4例得到较大改善,所有病例术后均无明显瘢痕。结论:内眦赘皮是由内眦韧带至皮肤纤维连接及眼轮匝肌错构形成,经重睑入路的内眦赘皮矫正术在改善内眦赘皮的同时避免了内眦部瘢痕的产生,尤其适用于同时行重睑术的轻中度内眦赘皮患者。

Objective According to the anatomic study of the medial canthal to discuss the the clinical application of the Epicanthoplasty by double eyelid approach.Methods Anatomical and histological study of the medial canthal of 9 preserved cadaver were performed.We separated the medial canthal widely to interrupt the fiber connection between the medial canthal ligament and the skin,then remove parts of the orbicularis oculi which walking confused and disorderly by a double eyelid incision.Results There was conspicuous fiber connection between the anterior branch of the medial canthal ligament and the overlying skin.The orbicularis muscle can be observed across the medial canthal ligament in some samples.Follow-up on 42 patients after 1～6 months,31 cases of 35 mild to moderate patients were significantly improved,4 cases of 7 severe patients were greatly improved,all cases had no obvious scar.Conclusion It was the reason of epicanthus that the fibers from the anterior branch of the medial canthal ligament to the skin and the orbicularis oculi walking confused and disorderly.The epicanthoplasty by double eyelid approach can be used to correct the epicanthus without the scar of the medial canthal,especially for mild to moderate epicanthus patients simultaneously with blepharoplasty.