下颌瞬目综合征的研究进展

Research progress on Marcus Gunn jaw-winking syndrome

MarcusGunn下颌瞬目综合征（Marcus Gunn jaw—winking syndrome，MGJWS）是一种较为少见的面部联合运动症状，表现为下颌一眼睑联合运动，常伴有上睑下垂，下垂的眼睑遮挡视轴可引起发育性眼病，同时可因颌动瞬目造成心理发育等方面的问题，故需早期干预治疗。目前针对MGJWS的两个主要症状颌动瞬目现象及上睑下垂的手术方式，包括改良版提上睑肌折叠术、提上睑肌额肌吻合术以及提上睑肌离断联合额肌瓣悬吊术等，但对于哪种手术方式对于MGJWS的疗效最好尚无定论。近期研究发现并非所有MGJWS患者皆需手术治疗，轻度MGJWS可暂行观察，中重度MGJWS患者或者当MGJWS患者出现持久的眼部功能问题或者外观问题时，应考虑手术。患眼提上睑肌离断术联合同侧额肌瓣悬吊术步骤简单、创伤适中、术后疗效稳定，为目前较为理想的手术方式。

Marcus gunn jaw-winking syndrome（MGJWS） is a rare kind of facial synkinesis which is manifested as mandibular-eyelid synkinesis, usually accompanied with blepharoptosis. Developmental ocular diseases may be caused since ptosis occluding the visual axis, and the jaw-winking phenomenon may cause some psychological issues. Thus, early intervention is essential. At present, several operation methods, in- cluding modified levator plication, anastomosis of levator with frontal muscles and frontalis suspension with levator disabling, have been proposed toward the main two symptoms of MGJWS, jaw-winking synkinesis and blepharoptosis. Still, there＇ s no common consensus on which surgical method is the most optimal solution for MGJWS. Researches discovered that operation is not essential for every patient. For mild MGJWS, observa- tion should be considered first. Operation is recommended for moderate or severe MGJWS and patients who present persist function problems or appearance issues. At present, unilateral levator excision and frontalis suspension is an ideal surgical method since its convenience, less anatomy destruction and steady postoperative effect.