移植技术联合重睑成形术在上睑缺损畸形美容性修复中的应用

The application of transplant techniques combined with double eyelid technology for upper eyelid defect reconstruction

目的：探讨利用移植技术联合重睑成形术修复上睑缺损的方法及临床意义。方法：根据上睑缺损程度、部位，选择眼睑皮肤移植、眼轮匝肌肌皮瓣以及扩张超薄皮瓣等方法进行修复，同时行重睑成形术。结果：20例患者中，利用对侧上睑皮肤游离移植修复上睑缺损5例，利用眼轮匝肌肌皮瓣旋转、推进修复上睑皮肤缺损10例，利用扩张超薄皮瓣修复上睑皮肤缺损5例。术后无皮瓣坏死、无供区继发畸形等并发症，随访3～18个月，功能恢复完全，形态满意，双侧眼睑睁、闭眼时的动态表情一致。结论：对于外伤后瘢痕或良性肿瘤切除后所致的上睑缺损畸形，利用重睑成形技术的修复，实现了上睑功能和神态的同时恢复，且不遗留供区畸形，是一种设计合理、灵活、具有个性化的美容性修复方法。

Objective To investigate the use of transplant techniques combined with double eyelid technology for upper eyelid defect reconstruction and the significance of clinical application.Methods According to the degree and location of upper eyelid defect, selected the methods of eyelid skin grafting,local flaps,orbicularis oculi myocutaneous flaps or expanded super-thin flaps, and combined with double eyelid surgery simultaneously. Results 20 patients with different kinds of upper eyelid defect underwent this method of treatment,5 cases for using of the contralateral upper eyelid skin graft,10 cases for using of the orbicularis oculi myocutaneous flaps rotating or advancing, and 5 cases for using of expanded super-thin flap.Follow up for 3 to 18 months postoperatively showed there was no flap necrosis,secondary deformity and other postoperative complication occurred,the function recovered satisfactory and the bilateral eyelids played the expression consistently. Conclusion To restore the upper eyelid defect after traumatic scar or benign tumors resection,the use of double eyelid technology can achieve both function and appearance recovery, and no donor site malformation left,this is a cosmetic reconstructive method with rationalization, flexibility and personalization.