额肌筋膜瓣悬吊术矫正上睑下垂的实验研究

Experimental study of blepharoptosis treated by frontalis muscle fascia flap suspension

目的 研究小型实验猪作为上睑下垂模型的可行性及观察额肌筋膜瓣悬吊术后额肌筋膜瓣远期的转归.方法 选取8头3个月龄小型实验猪,采用自身对照,通过结膜入路切除上睑提肌腱膜将一侧上睑制成上睑下垂模型,并于1个月后采用额肌筋膜瓣悬吊术矫正上睑下垂,对侧作为对照.术后定期观察上睑下垂模型建立后以及上睑下垂矫正术后的上睑外形、高度变化等,术后6、12个月分别取双侧上睑额肌组织进行光镜及透射电镜组织学观察.结果 上睑下垂模型建立术后,所有猪均呈现典型的重度上睑下垂外观,额肌筋膜瓣悬吊术后上睑弧度形状良好,两侧睑裂基本对称.组织学观察显示,术后6、12个月额肌筋膜瓣额肌纤维形态及结构正常,未发生明显萎缩和退变.结论 本研究建立了小型猪上睑下垂动物模型,应用额肌筋膜瓣悬吊矫正上睑下垂,术后6、12个月额肌筋膜瓣额肌纤维形态和结构良好,未发生明显萎缩退变,可认为是额肌筋膜瓣悬吊矫正上睑下垂具有较好远期效果的原因.

Objective To study the suitability of miniature pigs as eyelid ptosis model and observe the long-term histological changes of the eyelid ptosis treated with frontalis muscle fascia flap suspension, netho ds Eight 3-month miniature pigs were selected as the experimental animals using homebody comparison. One side of upper eyelid was treated to become severe ptosis by resection of levator aponeurosis while the other side served as the control group. Regular observation of the gross appearance of the upper eyelid and the upper eyelid-frontalis muscle flap composite tissue of 6-month and 12-month after ptosis repair was obtained and studied through light microscopy and transmission electron microscopy. Results All the miniature pigs appear sevre ptosis after the model were constructed. The appearance turned to be good with symmetry of the control side after the frontalis muscle fascia flap suspension procedure. The histological study revealed that the frontalis muscle fascia flap have undergone no obvious regression and fibrosis 6-month and 12-month after surgery. Conclusion The miniature pigs have the potential to be severe ptosis model. The frontalis muscle fascia flap have pre- served good structure and shape without regression and fibrosis. This enables a more long-lasting and nature post-operation effect than other procedures.