提上睑肌腱膜瓣—额肌吻合术在治疗儿童重度上睑下垂中的应用

对重度上睑下垂的矫治,我们改良传统的手术方式,采用提上睑肌位膜瓣—额肌吻合术治疗26例36眼儿童先天性重度上睑下垂,取得了良好效果。制作提上睑肌腹膜瓣、额肌分离、隧道制作是确保手术成功的三个重要步骤,而制作提上睑肌腱膜瓣则是这三个步骤中的关键步骤。本文对这三个手术步骤作了讨论。为充分暴露额肌,便于制作额肌组织瓣,利于提上睑肌腱膜瓣与额肌吻合,本组病例加作了眉毛下中部辅助切口。本组病例对以往“额肌筋膜瓣”作了改进,额肌分离只制成片状组织瓣,其两侧不与剪开,上下分离达眉上缘区即可,以减少损伤,既克服了额肌筋膜瓣方法时两侧剪开,剥离范围大出血多的缺点,又加强了额肌悬吊的力量。本文对儿童重度上睑下垂手术矫治谈了我们的做法和体会。

The Use of Levator Palpebrae Superioris Musculoaponeurotic Flap-Frontalis Anastomosis in the Treatment of Children Severe Ptosis of the Eyelid

AlthoUg ther were a lot of ways in the treatment of severe ptosis of the eyelid they allhad ra faults, especially the report about the treatment of children severe ptosis of the eyelid. Meffects have been made in the treatment of 26 cases (36 eyes) with children severe ptosis of the eyelid.With wodified levator palpebrae superioris musculoaponeurotic flap - frontalis anastomosis. Making levator palpebrae superioris musculoaponeurotic flap - frontalis separated, and channel made were threeimportant steps of ensuring operation success. Primary "frontal aponeurosis flap" was modified in thestudy. Not only it overcomed the fault of bilateral incision frontal aponeurosis flap, over range andhemorrhage but also improved the force of frontal suspension. In order to benefit anastomosis betweenlevator palpebrae superioris musculoaponeurotic flap and frontalis. Affiliated incisions were done in allcases at median - inferior eyebrow.