留Mller氏肌之提上睑肌缩短术矫治上睑下垂

Surgical treatment of ptosis by levator palpebrae superioris muscle resection with reservation of the function of Müller′s muscle

目的 使提上睑肌缩短术损伤更小、更符合生理功能。方法 根据上睑解剖 ,改进传统的提上睑肌缩短术 ,提出留M櫣ｌｌｅｒ氏肌之提上睑肌缩短术?臼跏降墓丶谴与炷ぶ猩?1/3交界处剪断腱膜和M櫣ｌｌｅｒ氏肌 ,并将远断端与提上睑肌肌腹缝合 ,使M櫣ｌｌｅｒ?终帕Χ⒒幼饔谩=峁×俅灿τ媒弥紊享麓?18例 ,术后经 2～ 18个月的随访观察 ,除 1例矫正不足外 ,余均获良好效果。结论 该术式操作方便 ,损伤小 ,保留了M櫣ｌｌｅｒ氏肌原有的功能 ,术后效果可靠。

Objective To reduce the damage of levator palpebrae superioris muscle resection and to have it more corresponding to the physiologic function. Methods According to the anatomy of upper eyelid region, the author improve the traditional operation method and report levator palpebrae superioris muscle resection reserving the function of Müller′s muscle. The key of operation is that the levator aponeurosis and the Müller′s muscle were cut off on the border between the upper 1/3 and middle 1/3 of the levator aponeurosis, and the distal stump was sewed up to the levator palpebrae superioris muscle in order to keep the tension of the Müller′s muscle. Results It has been applied clinically to correct ptosis in 18 cases. Through follow-up of 2 to 18 months, it is found that all are excellent except in one case. Conclusion The operation is convenient, it′s damage is little, and the function of Müller′s muscle is kept well. The effect is reliable and lasting.