眶周全肌切除术治疗特发性眼睑痉挛的有效性和安全性

目的 探讨眶周全肌切除术治疗特发性眼睑痉挛的有效性和安全性.方法 回顾性病例分析.1999年至2002年间我院收治的采用眶周全肌切除术治疗的43例特发性眼睑痉挛患者纳入研究.术后随访12个月,比较术前术后眼睑痉挛分级级别,并观察术后并发症.结果 43例特发性眼睑痉挛患者术后眼睑痉挛分级均明显降低,术后随访12个月,12例术前睑痉挛为3级者,术后均为0级,完全矫正.31例术前4级者,术后4例为0级;25例为l级,2例为2级.无一例出现眼睑闭合不全.结论 对临床分级3～4级的特发性眼睑痉挛患者,眶周全肌切除术疗效确切.手术效果与病情临床分级相关.

Safety and effectiveness of complete resection of the periorbital muscle for treating essential blepharospasm

Objective To estimate the safety and effectiveness of complete resection of the periorbital muscle for treating essential blepharospasm.Methods This study was a retrospective analysis.Forty-three patients diagnosed with essential blepharospasm were treated by completely resecting the periorbital muscles under local anesthesia.The effectiveness of the method was based on the grading norm of clinical blepharospasm,using the preoperative and postoperative contrasts,and conducting a follow-up survey during the 12 months postoperatively to identify eyelid dysraphisms or other complications.Results Among the 43 patients,preoperative blepharospasms were grade 3 and postoperative blepharospasms were grade 0 in 12 patients; the other 31 patients were grade 4 before surgery and after surgery were grade 0 in 4 patients,grade 1 in 25 paitients,and grade 2 in 4 patients.No eyelid dysraphism was found in the follow-up survey.Conclusion For clinical grading levels 3-4 in patients with idiopathic blepharospasm,comprehensive orbital muscle resection is useful and effective.The effectiveness of the procedure depends on the severity of the illness：the more severe preoperative,the less ideal effect.