应用眶隔筋膜瓣与额肌瓣治疗重度上睑下垂的美容学意义探讨

To explore a beautiful method of using orbital septum aponeurosis flap and frontal muscle flap to correct serious blepharoptosis

目的探讨一种矫治重度上睑下垂的美容有效方法。方法术中制作一蒂在眶隔筋膜与提上睑肌结合部之上的眶隔筋膜瓣,在眉区分离额肌筋膜瓣,将额肌筋膜瓣插入眶隔筋膜与提上睑肌之间,三瓣重叠牢固缝合,悬吊上睑矫正上睑下垂。结果采用此法对12例12侧重度上睑下垂进行治疗,随访6~18个月,平均1年,其中,10只眼睛满意,1只好转,1只眼睛上睑外侧偏低重新修复后正常。结论利用眶隔筋膜、额肌、提上睑肌腱膜三瓣吻合术矫正重度上睑下垂,上睑悬吊牢靠,眼部上提接近生理,睑缘弧度自然,达到美容治疗双重功效,是一种可以推广的美容方法。

Objective To explore a beautiful method of treating serious blepharoptosis. Methods To form the frontal muscle flap and orbital septum aponeurosis flap, the frontal muscle flap was overlapped between levator palpebrae superioris and orbital septum aponeurosis flap; two flaps and levator palpebrae superioris were overlapped and sutured in order to suspend the upper eyelid to correct serious blepharoptosis.Results 12 cases with 12 eyes were treated with this method. Postoperative follow-up for 6 months to 18 months showed that the efficacy of 10 cases was satisfying, symptom in one case improved,and one case needed a second reconstruction. Conclusion Through this method for correction of serious recurrent blepharoptosis by suspension offrontal muscle flap overlapped with levator palpebrae superioris and orbital septum aponeurosis flap, a better function and cosmetic result could be achieved. The eyelid system that it forms is very consonant with the biological structures.