眶隔筋膜瓣与额肌瓦合固定矫正重度上睑下垂

Correction of severe blepharoptosis by suspension of frontal muscle flap overlapped with orbital septum aponeurosis

目的:研究利用眶隔筋膜瓣与额肌瓦合固定矫正重度上睑下垂的临床效果。方法:术中于眼轮匝肌下分离并显露眶隔至近眶上缘处,在眶隔表面设计一蒂位于睑板前面的梯形瓣。在眉上缘切开皮肤,于眼轮匝肌表面锐性游离至近眶上缘区、横形剪开肌层1cm宽,形成隧道,将眶隔筋膜组织瓣经隧道上提眉区额肌表面、与额肌瓦合固定。结果:作者利用该术式对15例19只眼、其中5只眼为复发性病例进行治疗,临床效果满意,两眼外形对称,睑缘弧线好、重睑自然,无睑内外翻、睑球分离、闭眼不全现象。6个月随访12只眼,1只眼好转,11只眼矫正效果保持良好状态。结论:作者利用眶隔筋膜组织瓣与活动度较大的眉部额肌瓦合固定,具有固定牢固、眉部额肌无损伤、肌力长久、活动范围大、不易复发等优点,而且睑缘弧度好、重睑自然、并发症少,优于传统的额肌悬吊术。

Objective To inventing a new method for Correction of severe blepharoptosis by suspension of frontal muscle flap overlapped with orbital septum aponeurosis.Methods Frontal muscle flap and obital septum aponeurosis flap were formed in the frontal part and upper eyelid respectively.Two flaps were overflapped and sutured to suspend the upper eyelid and to correct severe blepharoptosis.Results 15 cases（19 eyes） with severe blepharoptosis,5 of which were recurrent,were treated by suspension of frontal muscle flap overlapped with orbital septum aponeurosis.All of them got satisfactory clinical effect.None of them had separation of eyelid from eyeball,ectropion and other complications.12 eyes were follow-up and analyzed restrospectively in 6 months.11 eyes of blepharoptosis were completely corrected and 1 eye took a favourable change.Conclusion Through this method for correction of severe blepharoptosis by suspension of frontal muscle flap overlapped with orbital septum aponeurosis,that have a better result than traditional frontal muscle flap suspension,could we get better improvement in the function and reshaping effect.