额肌腱膜瓣治疗中重度上睑下垂

Frontalis Aponeurosis Flap Suspension in the Treatment of Moderate and Severe Blepharoptosis

目的 探讨改良额肌腱膜瓣设计矫治中重度上睑下垂的方法和效果。方法 根据额肌的神经支配和供血特点 ,设计额肌腱膜内外侧分别向外上方斜 6 0°切开 2 0mm和 5mm的额肌腱膜瓣悬吊上睑 ,术中注意保护Muller肌和后鞘下脂肪垫。结果 4 6例中重度上睑下垂 ,效果满意 39例 ,良好 5例 ,不佳 1例 ,通过随访 3个月～ 1年无并发症发生。结论 本设计方法不损伤支配额肌的神经血管 ,并充分利用眶眉区的解剖特点 ,可达到较满意的疗效 ,且安全可靠。

Objective To investigate the method and effect of the modified design of frontalis aponeurosis flap to correct the moderate and severe blepharoptosis.Methods Based on the character of nerve innervation and vessel apply of frontalis muscle the medial and lateral frontalis apponeurosis were incised for 20 mm and 5 mm long upward and laterally in 60° respectively. The upper eyelid was suspended on the frontalis apponeurosis flap.The Muller's muscle and fat pad behind the posterior sheath were protected carefully in operation.Results Forty-six cases of moderate and severe blepharoptosis were treated since 1994,of which 39 cases were corrected satisfactorily,5 cases were corrected mostly and one case was failed with follow-up from 3 months to 1 year.There were no complications.Conclusion The above mentioned technique don't injury the nerves and vessels of frontalis muscle and utilise the anatomic character of eyebrow and orbit region sufficiently,may be an effective and dependable method to correct moderate and severe blepharoptosis.