保留面神经功能的额肌瓣转移术在重度上睑下垂患者的治疗效果

Therapeutic effect of modified frontal muscle flap transfer with facial nerve function fully preserved in the correction of severe blepharoptosis

目的探讨保留面神经功能的额肌瓣在治疗重度上睑下垂患者的效果,观察复发情况.方法2005年5月至2019年5月,对中国医学科学院整形外科医院收治的17例26眼(男10例,女7例,年龄8~33岁,平均17.6岁)重度上睑下垂患者采用改良的三角形额肌瓣治疗,术后进行疗效评估及满意度调查.术后随访6个月至10年.结果患者上睑下垂得到较好的矫正,睁眼、闭合功能恢复达到正常状态,26眼中24眼治愈,2眼基本治愈,无1例出现复发或上睑回缩.14例患者对治疗效果非常满意,2例基本满意,1例不满意.结论内上方的三角形额肌瓣转移术能够安全有效地矫正上睑下垂,保留面神经功能,避免神经传导障碍引起的额肌瓣瘫痪,减少复发率.

Objective To study the therapeutic effect of modified frontal muscle flap with facial nerve function preserved in the treatment of severe blepharoptosis,and to observe its therapeutic effect and recurrence rate.Methods From May 2005 to may 2019,17 patients(26 eyes)with severe blepharoptosis were treated with modified triangular frontalis muscle flap.The curative effect and sat-isfaction were evaluated.Results After 6 months to 10 years'follow-up,the patients with blepharop-tosis were well corrected,and the function of opening and closing was restored to normal.24 eyes in 26 eyes were cured,and 2 eyes were basically cured.No recurrence or retraction of the upper eyelid occurred.14 patients were very satisfied with the treatment effect,2 were basically satisfied,1 was not satisfied.Conclusions The transfer of the triangle frontalis flap in the upper part of the eyelid can correct the blepharoptosis effectively,and keep the function of facial nerve fully,then avoid the paral-ysis of frontalis flap caused by nerve conduction obstacle,which can reduce the recurrence rate.