改良皮肤睑板部分切除、上睑提肌Müller氏肌折叠术矫正后天性上睑下垂

采用改良Ｊａｍｅｓ术式治疗后天性上睑下垂１３例１９只眼，效果满意。对手术方法、适应证等进行了讨论。认为是矫正上睑下垂的有效方法，但术式稍嫌复杂。     

留Müller氏肌之提上睑肌缩短术矫治上睑下垂

目的使提上睑肌缩短术损伤更小、更符合生理功能 .方法根据上睑解剖,改进传统的提上睑肌缩短术,提出留Mülle r氏肌之提上睑肌缩短术.本术式的关键是从腱膜中上1/3交界处剪断腱膜和Müller氏肌, 并将远断端与提上睑肌肌腹缝合,使Müller保持张力而发挥作用.结果临床应用矫治上睑下垂18例,术后经2～18个月的随访观察,除1例矫正不足外,余均获良好效果.结论该术式操作方便,损伤小,保留了Müller氏肌原有的功能,术后效果可靠、持久.     

Müller氏肌缩短术治疗麻痹性上睑下垂

针对交感神经麻痹性上睑下垂的病理发病机制,应用 Müller 氏肌缩短术治疗21例23只眼,获得满意疗效。对术前病例选择、手术方法作了介绍,讨论了 Müller 氏肌的生理功能,认为 Müller 氏肌缩短术是交感神经麻痹性上睑下垂的最佳手术方法。     

Müller氏肌缩短术治疗麻痹性上睑下垂

针对交感神经麻痹性上睑下垂的病理发病机制，应用Ｍüｌｌｅｒ氏肌缩短术治疗２１例２３只眼，获得满意疗效。对术前病例选择、手术方法作了介绍，讨论了Ｍüｌｌｅｒ氏肌的生理功能，认为Ｍüｌｌｅｒ氏肌缩短术是交感神经麻痹性上睑下垂的最佳手术方法。     

改良皮肤睑板部分切除,上睑提肌Muller氏肌折叠矫正后…

采用改良Ｊａｍｅｓ式治疗后天性上睑下垂１３例１９只眼，效果满意。对手术方法，适应证等进行了讨论，认为是矫正上睑下垂的有效方法，但术式稍嫌复杂。     

留Mller氏肌之提上睑肌缩短术矫治上睑下垂

目的　使提上睑肌缩短术损伤更小、更符合生理功能。方法　根据上睑解剖 ,改进传统的提上睑肌缩短术 ,提出留M櫣ｌｌｅｒ氏肌之提上睑肌缩短术?臼跏降墓丶谴与炷ぶ猩?1/3交界处剪断腱膜和M櫣ｌｌｅｒ氏肌 ,并将远断端与提上睑肌肌腹缝合 ,使M櫣ｌｌｅｒ?终帕Χ⒒幼饔谩=峁×俅灿τ媒弥紊享麓?18例 ,术后经 2～ 18个月的随访观察 ,除 1例矫正不足外 ,余均获良好效果。结论　该术式操作方便 ,损伤小 ,保留了M櫣ｌｌｅｒ氏肌原有的功能 ,术后效果可靠、持久     

留Müller氏肌之提上睑肌缩短术矫治上睑下垂

目的使提上睑肌缩短术损伤更小、更符合生理功能 .方法根据上睑解剖,改进传统的提上睑肌缩短术,提出留Mülle r氏肌之提上睑肌缩短术.本术式的关键是从腱膜中上1/3交界处剪断腱膜和Müller氏肌, 并将远断端与提上睑肌肌腹缝合,使Müller保持张力而发挥作用.结果临床应用矫治上睑下垂18例,术后经2～18个月的随访观察,除1例矫正不足外,余均获良好效果.结论该术式操作方便,损伤小,保留了Müller氏肌原有的功能,术后效果可靠、持久.     

上睑提肌缩短联合睑板部分切除矫正重度先天性上睑下垂效果观察

目的:探讨上睑提肌缩短联合睑板部分切除术矫正重度上睑下垂的疗效。方法:对重度先天性上睑下垂44例49眼进行手术治疗,其中行上睑提肌缩短联合睑板部分切除术共24例26眼,额肌瓣悬吊术20例23眼,术后对上睑缘位置、上睑的弧度形态、眼睑闭合度及并发症情况进行随访,并据此评价手术疗效。结果:术后随访3~24个月,行上睑提肌缩短联合睑板部分切除术后上睑下垂矫正较满意,术后形态较好,并发症发生率低,明显优于额肌瓣悬吊术患者,二者差异有统计学意义(P0.05)。结论:上睑提肌缩短联合睑板部分切除术,符合眼睛的正常生理结构,术后并发症少,疗效满意。     

改良提上睑肌延长术联合Müller肌切除术治疗上睑退缩的疗效观察

目的：探讨改良提上睑肌延长术联合Müller肌切除术治疗上睑退缩的疗效。方法：选取2017年10月-2020年10月在笔者医院就诊的上睑退缩患者59例。对所有患者实施改良提上睑肌延长术联合Müller肌切除术。术后6个月,记录临床效果、眼睑及眼表指标、并发症和生活质量情况。结果：术后6个月,59例上睑退缩患者中,完全矫正42例（71.19%）,改善16例（27.12%）,无效1例（1.69%）,总有效率为98.31%(58/59)。术后,患者睑裂高度、上方巩膜露白均低于术前,上睑覆盖角膜高度高于术前,差异有统计学意义（P<0.05）;术前术后患者上睑肌力比较,差异无统计学意义（P>0.05）。术后,患者泪膜破裂时间、泪液基础分泌试验长度均优于术前,差异有统计学意义（P<0.05）。59例上睑退缩患者中,4例患者有不同程度的眼睑肿胀,患者均无感染、血肿、颞侧巩膜暴露、复发等并发症。术后,患者生活质量评分均高于术前,差异有统计学意义（P<0.05）。结论：改良提上睑肌延长术联合Müller肌切除术在上睑退缩治疗中疗效确切,能减轻临床症状,改善患者生活质量,且并发症少...     

亚洲人上睑提肌-Müller肌复合体组织解剖学研究进展

局部精细解剖学是美容手术的重要基础.作为上睑的主要功能性组织结构,上睑提肌-Müller肌复合体是提升上睑以完成睁眼动作的主要动力来源.因此,深入认识、理解上睑提肌-Müller肌复合体及其毗邻结构的精细解剖学,是有效开展并发展上睑美容整形手术的前提.本文对有关亚洲人上睑提肌-Müller肌复合体及其毗邻结构的组织解剖...     

Multilevel full-thickness eyelid resection for the correction of severe acquired ptosis in the poorly functioning eyelid

Six eyelids (4 patients) with severe myogenic (4 eyelids), neurogenic (1 eyelid), or mechanical (1 eyelid) ptosis underwent surgical correction with a multilevel full-thickness resection of eyelid tissue combined with a plication of the levator aponeurosis-Müller's muscle complex. All eyelids had poor levator function, fair to poor orbicularis function, and a poor Bell's phenomenon. In all cases, the upper eyelids were elevated to an acceptable functional level without exposure keratopathy. This resection procedure preserves orbicularis function while allowing correction of severely ptotic eyelids with poor levator function, providing an acceptable alternative to other techniques for correcting this problem.     

Upper eyelid ptosis correction by a revised tarsal resection technique

Many techniques have been developed for the correction of eyelid ptosis. A new tarsal plate resection technique is described for use in cases of minimal ptosis with fair to good levator function. The procedure involves a horizontal lenticular excision of the tarsal plate, placed so that equal amounts of tarsus remain above and below the excision. The height of the excision is equal to the amount of ptosis correction desired, as determined in the preoperative examination. This precision in surgical correction is the chief advantage of the procedure. The technique also spares Müller's muscle, thus retaining the lid-elevating action of that muscle. Good results have been achieved in 6 patients, some showing excellent results after nine years.     

Treatment of congenital and acquired upper eyelid ptosis: report of 131 consecutive cases

In this paper, a 5-year experience in the management and surgical treatment of upper eyelid ptosis at the Plastic Surgery Institute of Milan University Medical School is presented. From September 1992 to April 1996 a total of 131 consecutive cases were treated surgically. The patients are grouped into three categories: those with good residual function of the levator muscle in which a levator resection procedure was performed; those with poor residual function in which a frontalis suspension was selected; and those with moderate residual function in which levator surgery was the initial treatment, followed by a second operation (frontalis suspension) in unsatisfactory results. At postoperative follow-up, 101 cases were rated good, 22 were fair, and nine were poor. Early and late complications are discussed, together with some important key-points in the management and surgical treatment of the patients. Received: 31 December 1999 / Accepted: 6 May 2000     

上睑提肌缩短术矫正重睑过宽伴上睑下垂

目的 探讨通过上睑提肌缩短矫正重睑过宽伴上睑下垂的有效方法.方法 对78例重睑过宽的患者重新设计重睑线,松解原重睑线的粘连,将上睑提肌缩短,睑缘上移,以解决重睑过宽、睁眼乏力、轻度上睑下垂的问题.结果 术后随访6～24个月,所有患者的重睑形态良好,效果满意.结论 手术造成的重睑过宽、睁眼乏力、轻度上睑下垂,均可通过上睑提肌缩短术予以矫正,是值得临床推广的矫止多次重睑术后并发症的有效方法.     

New adjustable suture technique for managing eyelid ptosis.

The challenge of accurately predicting eyelid height after levator surgery for ptosis is a well-known problem even in competent hands. It is always better to correct an unfavorable postoperative result without surgical intervention, and thus spare the patient another involved procedure. The author describes a new adjustable suture technique that ensures a secure connection between the levator muscle and the tarsus, and allows easy postoperative adjustment of lid height. The suture design consists of an inner and an outer loop in a configuration that resembles a paper clip. When the suture is tightened, the inner loop approximates the distal part of the levator muscle to the tarsal plate, bringing the tissues into secure contact. When tightened further, the outer loop is activated and it approximates the more proximal part of the levator muscle to the tarsus as much as desired to achieve the proper eyelid height. When the sutures are tightened, the levator muscle shortens by folding on itself like the pleats of an accordion. Using this method, muscle slack is reduced as the tissue is folded on itself several times.