联合筋膜鞘悬吊矫正额肌瓣及上睑提肌缩短术后重度上睑下垂的临床效果

Treatment of recurrent severe blepharoptosis after frontal muscle flap suspension and levator palpebrae superioris shortening with conjoint fascia sheath suspension

目的探讨用联合筋膜鞘悬吊矫正额肌瓣及上睑提肌缩短术后复发重度上睑下垂的临床疗效。方法2017年2月至2018年4月,空军军医大学西京医院整形外科用该方法修复额肌瓣及上睑提肌缩短术治疗后复发重度上睑下垂19例(21只眼),男12例,女7例;年龄26~61岁。结果术后随访3~12个月,14例患者双眼基本对称,重睑形成良好,上睑缘高度在角膜上缘下1~2 mm处,弧度良好,无明显睑裂闭合不全。其中3例术后发生结膜脱垂,1个月后恢复;2例术后1个月发现眼睑位置矫正不足,术后6个月经原切口打开重新缝至联合筋膜鞘,眼睑位置恢复正常,双眼睑对称。19例患者术后无暴露性角膜炎、睑内外翻、倒睫、感染等并发症。结论联合筋膜鞘悬吊矫正额肌瓣及上睑提肌缩短术后复发重度上睑下垂是一种较好的方法。

Objective To investigate the clinical effect of conjoint fascial sheath(CFS)suspension to correct the complications caused by the frontal muscle flap suspension and levator palpebrae superioris shortening in the treatment of severe blepharoptosis.Methods From February 2017 to April 2018,19 severe blepharoptosis patients(21 eyelids)were operated before by the frontal muscle flap suspension and levator plapebrae superioris shortening,and repaired through the technology of CFS suspension.Results There were 19 cases,17 cases operated by CFS suspension showed a good appearance and basically symmetrical of two eyes,and the other 2 cases obtained satisfactory results though reoperation.There were no complications of exposure keratitis,ectropion and infection occurred.Meantime the effect was satisfactory according to the follow-up ranging from 3 months to 12 months.Conclusions The application of conjoint fascial sheath(CFS)suspension shows a promising procedure in the treatment of severe blepharoptosis caused by the frontal muscle flap suspension and levator palpebrae superioris shortening.