瘢痕眼轮匝肌瓣修复过宽重睑效果分析

Efficacy of scar orbicularis oculi muscle flap in the repair of excessively wide double eyelid

目的探讨重睑成形术后重睑线过宽、重睑皱襞凹陷伴上睑皮肤组织不足的有效修复方法。方法自2019年8月至2021年8月,北京澄真医疗美容诊所对25例双侧重睑线过宽、重睑皱襞处凹陷且上睑皮肤组织量不足者,利用瘢痕眼轮匝肌瓣行重睑修复术。术中重新设计重睑线,剥离切口下方皮肤与睑板之间的瘢痕眼轮匝肌瓣,翻转后填充于新旧重睑线之间的皮肤组织下,最后将切口下方皮肤、睑板、切口上方眼轮匝肌皮肤缝合形成重睑。结果术后随访3~12个月,其中23例术后重睑流畅、自然、双侧基本对称,无多重睑、上睑外翻、高低不对称等并发症发生;2例因重睑过高且皮肤松弛度不够,造成术后新旧重睑线之间皮肤与深部组织再次粘连,形成多重睑,效果欠佳。结论对于重睑线过宽伴上睑皮肤组织不足的患者,行瘢痕眼轮匝肌瓣修复,效果稳定,值得临床推广应用。

Objective To explore the effective repair method of excessively wide double eyelid,double eyelid fold depression with insufficient upper eyelid skin tissue.Methods From August 2019 to August 2021,25 patients who had excessively wide double eyelid of both sides,double eyelid fold depression and insufficient upper eyelid skin tissue were selected.The double eyelid was repaired by scar orbicularis oculi muscle flap.During the operation,the double eyelid fold was redesigned,the scar orbicularis oculi muscle flap between the lower lip skin and the tarsal plate of the incision was stripped.Then the scar orbicularis oculi muscle flap was turned over and filled under the skin tissue between the new and old double eyelid fold.Finally,the lower lip skin,tarsal plate,upper lip orbicularis oculi skin was sutured to form new double eyelid.Results All patients were followed up for 3 to 12 months.Twenty-three patients had natural and bilateral symmetrical double eyelid fold.No complications such as multiple eyelid folds,upper eyelid ectropion and asymmetry occurred.Two patients suffered from multiple eyelid folds after operation because of the high double eyelid creases and insufficient skin tissue of upper eyelid.Conclusion For patients with excessively wide double eyelid and insufficient skin tissue of upper eyelid,the efficacy of repair by scar orbicularis oculi muscle flap is stable.