上睑下垂矫正术联合微创内眦赘皮矫正术疗效分析

The effect of ptosis diorthosis combined with minimally invasive epicanthus surgery

目的探讨对伴有内眦赘皮的先天性上睑下垂患者行上睑下垂矫正术的同时，在显微镜下联合内眦赘皮矫正术的疗效。方法对1998～2013年在施行的上睑下垂矫正术同时矫正内眦赘皮的病例56例。其中提上睑肌缩短术联合内眦赘皮矫正术25例，额肌悬吊术联合内眦赘皮矫正术31例。用改良新月形去皮法矫正眉部型内眦赘皮；皮肤-肌肉双层成形术法矫正眦距不远者的睑部型、睑板型内眦赘皮；Y—V成形术法合并内眦韧带折叠或缩短术矫正眦距过远者睑部型、睑板型内眦赘皮；用L形皮肤切除法矫正倒向型内眦赘皮；不同类型的内眦赘皮应用不同的手术方法在显微镜下用显微器械联合微创内眦赘皮矫正术。结果56例术后均Ⅰ期愈合，内眦角显露，内眦赘皮消失，上睑下垂矫正。结论对伴有内眦赘皮的先天性上睑下垂患者，行上睑下垂矫正术的同时联合内眦赘皮矫正术，手术效果确切，避免了患者再次手术的痛苦，值得推广应用。

Objective To investigate the effect of congenital ptosis diorthosis combined with simultaneous epicanthus diorthosis under microscope. Methods Fifty-six patients who performed congenital ptosis diorthosis combined with simultaneous epicanthus diorthosis were included in this study. This study included 25 cases of eyelid muscle shortening surgery combined with angular flabby skin diorthosis and 31 cases of frontal muscle suspension surgery combined with flabby skin diorthosis of inner cantbus. A modified crescent peeling method was used for brow type epicanthus; skin-muscles double keratoplasty method was used for the epicanthus that was not far from the intercanthus angle; inner canthal ligament foldingas used for the epicanthus that was far from the intercanthus angle; and L-shaped skin excision was used to rectify backward type epicanthus. All surgery was performed under a microscope. Results All cases experienced postoperative Ⅰ healing with disappeared inner canthus epicanthus and ptosis. Conclusions Congenital ptosis diorthosis combined with minimally invasive epicanthus diorthosis can effectively treat ptosis and epicanthus simultaneously. This surgery strategy can avoid the patient pain caused by second operation, thus it is worthy of popularization and application.