改良三点式重睑成形术的临床应用研究

目的:探讨改良三点式重睑术的临床应用疗效。方法:2012年6月-2019年6月,共165例单睑患者采用了改良三点式重睑术,沿术前标记线将三点处皮肤切开,剪刀将切口下唇的眼轮匝肌适当去除,同时将切口与切口在皮下层打通,剪除切口与切口之间的眼轮匝肌,6-0可吸收线挂睑板前筋膜或提上睑肌腱膜及切口下唇皮下组织缝合,三点切口各缝1针。再用6-0单丝尼龙线按照常规重睑线缝合方法挂切口下唇皮肤、睑板前筋膜或提上睑肌腱膜及切口上唇皮肤缝合打结,三点切口各缝1针。伴内眦赘皮者同时行内眦赘皮矫正术。结果:152例患者获得随访,随访患者大部分获得了比较满意的重睑,睁眼重睑流畅、自然,闭眼刀口痕迹不明显。2例患者出现内侧重睑线变浅,1例患者出现外侧重睑线变浅,所有患者均未出现重睑消失。5例患者双侧重睑线有轻度不对称。患者总体满意率为94.7%(144/152)。结论:改良三点式重睑术具有创伤小、并发症少、效果逼真、不易脱落、手术痕迹不明显等优点,值得推广应用。     

改良睑黄色瘤切除手术的观察

目的 观察改良睑黄色瘤切除术的应用效果。方法 选择病灶〈10mm以下的瘤体为手术观察对象，共22例（38眼）。按超皮损病灶边界1mm设计切口缘，梭形切除病灶，深达真皮层，在显微镜下清除皮下组织及切缘脂肪组织，松解切口边缘皮肤，连续皮内缝合切口。另外，酌情行上睑松弛矫治术。结果 失访2例（2眼），随访20例（36眼）6—12个月，未见黄色瘤复发，切口平整，痕迹隐约。结论 采用改良睑黄色瘤切除术更会增强眼睑形态美感。     

改进的内眦赘皮矫治术联合重睑成形术Ⅰ期成形

目的 探讨改进的内眦赘皮矫治术联合切开法重睑成形术的方法及临床效果。方法 根据内眦赘皮的轻重程度及方向，采用改良的“Z”成形术，切除或切断内眦部形成赘皮的异位眼轮匝肌及皮下筋膜组织，联合切开法重睑成形术行Ⅰ期成形。结果 本组68例患者，术后赘皮消失，泪阜显露适中，内眦间距缩短，重睑外形美观自然。其中，36例随访3个月至3年，术后皮肤切口无可见瘢痕，形态稳定，内眦赘皮无复发，效果满意。结论 该手术方法能够充分矫正内眦赘皮的异常结构，而与重睑成形术同期施术效果稳定，具有一定的临床应用价值。     

Lower Lid Blepharoplasty—The Transconjunctival Approach: Extended Indications

The transconjunctival blepharoplasty is an elegant and secure technique especially in young people and helps to avoid the hazard of a scar. In older patients, it saves them the possible sequelae such as rounding sclero show or possible ectropion after a classical operation. Because there is no visible scar, the transconjunctival approach respects the integrity of the functional structure of the orbital septum and the orbicular muscle, the active support of the lower eyelid.     

Safety and efficacy of combined upper blepharoplasties and open Coronal Browlift: A consecutive series of 600 patients

Surgical rejuvenation of the upper face involves the correction of excess and lax forehead, eyelid, and periorbital skin. Improving the appearance by correcting the effects of aging involves a combination of blepharoplasty and open coronal foreheadplasty. Many surgeons and several reports question the safety of both procedures being performed concomitantly. The difficulty arises in precisely balancing the skin excision from the frontal forehead and upper eyelid areas. Over-resection of skin may result in incomplete closure of the eyelid and dry-eye syndrome, while an inadequate resection may produce a poor aesthetic result. There is no large series that documents the safety and effectiveness of these two procedures being performed concomitantly. Furthermore, with the recent and rapid development of complex multiplanar endoscopic facial rejuvenation techniques, the basic open forehead-plasty has become increasingly overlooked as a legitimate, efficacious technique for rejuvenation of the upper face. The technique utilized in this series is presented in detail. The consistently excellent results obtained satisfy the aesthetic goals of patients as well as the goals of surgeons, and suggest a renewed interest in the technique based upon its simplicity and easily reproducible results.     

Previously undescribed palpebral branch from the infraorbital canal: Application to surgery of the eyelid and treatment of orbital floor fractures

The sensory innervation of the inferior eyelid is mainly derived from the inferior palpebral branch (IPb) of the infraorbital nerve (ION). This study aimed to investigate another, to our knowledge, previously unknown branch, and elucidate its location and distribution. Twelve sides from seven fresh frozen cadaveric Caucasian heads were used in this study. The specimens were derived from two male and four female adult cadavers age. The diameter of the IPb of the ION (D1) and branch arising from the upper wall of the infraorbital canal (D2), and distance between the branching points of this branch and the anterior border of the orbit floor (L1) was measured. A branch to the lower eyelid was found arising from the infraorbital canal on the majority of sides. D1 ranged from 0.4 to 1.1 mm. The branch arising from the upper wall of the infraorbital canal was found 10 sides (83%). D2 ranged 0.6 to 1.0 mm. L1 ranged from 10.2 to 19.8 mm. All of the branches arising from the upper wall of the infraorbital canal (10 sides) primarily innervated to the inferior eyelid. We suggest this branch should be named the “posterior IPb” of the ION. Knowledge of this branch might decrease sensory loss following invasive procedures of the lower orbit. Clin. Anat. 30:835–838, 2017. © 2017Wiley Periodicals, Inc.     

地奥司明片治疗重睑成形术后上睑肿胀的临床研究

目的：探讨地皋司明片对重睑成形术后上睑肿胀的治疗作用。方法：将行重睑成形术患者，随机分为治疗组和对照组，治疗组术后口服地奥司明片，头孢丙烯，外用酒精消毒切口；对照组术后口服头孢丙烯，外用酒精消毒切口。结果：治疗组患者术后7天肿胀明显较对照组轻，患者自我满意度明显提高，未出现不良反应。结论：地奥司明片可以有效减轻重睑成形术后上睑肿胀，值得临床推广应用。