改进的额肌筋膜瓣悬吊矫正上睑下垂

Treatment of blepharoptosis by modified frontalis muscle-fascial flap suspension

目的 :评价改进的额肌筋膜瓣悬吊术治疗上睑下垂的疗效。方法 :在原额肌筋膜瓣悬吊术治疗上睑下垂的基础上进行改进 ,按重睑术切口切开皮肤、皮下 ,于眼轮匝肌和眶隔之间向上分离至眶上缘 ,横断额肌筋膜止点约 1cm ,先将之与眉皮下浅层分离 ,再自骨膜上掀起眉部额肌及筋膜 ,达眉上 1～ 1.2cm。结果 :用该法治疗 5 4例中、重度上睑下垂患者 ,疗效满意。结论 :本法减少额肌筋膜瓣的分离范围 ,仅用重睑切口即可完成上睑下垂矫正术 ,省去重睑切口上缘眼轮匝肌与浅层皮下的分离 ,操作简单 ,损伤小 ,出血少 ,缩短手术时间 。

Objective:To evaluate the effect of modified frontalis muscle fascial flap suspension in the treatment of blepharoptosis.Methods:We have improved on the conventional frontalis muscle fascial flap suspention in the treatment of blepharoptosis.The skin and hypodermis were incised along the supratarsal fold line,then the tunnel between the orbicularis ocularis muscle and orbital septum was made.The frontal muscle fascia was incised transversely 1 cm in its inserting level.Then the deep parts and the superficial parts of the frontal muscle fascial flap were dissected in succession.Results:Fifty four patients with blepharoptosis were treated using this modified frontal muscle fascial flap and the outcome was satisfactory.Conclusions:This approach minimizes the range of dissection,thus reducing the trauma,bleeding and operating time;futhermore,the superficial parts of the frontal muscle fascial flap being dissected firstly diminishes the injury to the flap so the operative outcome can be improved.