自体掌长肌腱游离移植辅助修复瘢痕性下睑外翻

Free autogenous palmaris Iongus tendon transplantation in treatment of cicatricial ectropion

目的探讨应用自体掌长肌腱移植辅助修复中、重度瘢痕性下睑外翻的方法和疗效。方法经患者近侧腕横纹部短小切口切取自体掌长肌腱，长度4～6cm。将肌腱游离移植于瘢痕松解后显露的患侧睑板前，与内外眦韧带的附着点及睑板做妥善固定，睑外翻矫正后的继发创面用局部皮瓣修复。结果共收治中、重度瘢痕性下睑外翻患者6例共8只眼。术后下睑外翻均获得矫治，随访6～18个月．均无睑外翻复发．无溢泪及角膜裸露症状，眼球与眼睑接触良好，下睑张力无减退，修复效果满意。结论掌长肌腱取材容易，供区无继发功能障碍，移植后上下眼睑对合紧密，睑外翻复发率低。手术效果满意，值得临床推广应用。

Objective To investigate the method and effect of free autogenous palmaris longus tendon transplantation in the treatment of moderate and severe cicatricial ectropion. Methods The au togenous palmaris longus tendon was obtained through a small lateral proximal wrist band incision （lengths from 4 cm to t3 cm）. The graft was properly sutured to the exposed tarsus and the attachments of inner and outer canthus. Local skin flap was rotated to cover the tendon and to repair the wound. Results Six man （8 eyes） with moderate and severe cicatricial ectropion were treated in our department, all case of ectropion were rectified after operation. The eyeballs were well contacted with lower eyelid and no recurrence of ectropion, epiphora and corneal exposure during 6 to 18 months＇ follow up. The tension of the lower eyelid was abiding with satisfied effects. Conclusions The palmaris longus tendon is easy to obtain and there is no harm to the donor site. The cicatricial ectropion could be repaired with self-palmaris longus tendon transplantation with lasting effect and the recurrence rate is lower, which is well worthy popularizing.