先天性上睑下垂眶隔后隧道额肌瓣悬吊术

目的 探讨经眶隔后隧道额肌瓣悬吊术治疗先天性上睑下垂的临床效果.方法 先天性上睑下垂48例(68眼),随机分为两组,A组:常规额肌瓣悬吊术治疗组18例(28眼).B组:经眶隔后隧道额肌瓣悬吊术治疗者30例(40眼).术后随访3个月～1年,观察比较两组的手术效果.结果 A组:治愈15例(25眼),欠矫2例(2眼),过矫1例(1眼).治愈率89.29％.B组:治愈26例(36眼),欠矫2例(2眼),过矫2例(2眼),治愈率90.00％.两组治愈率基本相同.所有患者术后早期均存在眼睑闭合不全情况,术后3个月均恢复正常.随访期间所有患者均无复发,上睑缘高度及睑缘弧度均较满意,眼睑闭合情况及额肌活动等均未见异常.结论 额肌瓣悬吊术是治疗上睑下垂的有效方法,而经眶隔后隧道额肌瓣悬吊术与常规额肌瓣悬吊术比较,减少了一个皮肤切口,避免了上睑臃肿现象,疗效更确切,并发症更少,能获得更好的美容效果.

Surgical treatment of congenital ptosis with frontalis muscle flap suspension through behind orbital septum

Objective To investigate the clinical effect of frontalis muscle flap suspension through tunnel behind orbital septum in treating congenital ptosis. Method 48 cases （68 eyes） with congenital pto- sis were divided into two groups： 18 cases （28 eyes） applied routine frontalis muscle flap suspension in group A. 30 cases （40 eyes） applied frontalis muscle flap suspension through tunnel behind orbital septum in group B. Observe and compare the curative effect after surgery follow up for 3 months - 1 year. Results Group A： cure：15 cases （25 eyes）, insufficient correction：2 cases （2 eyes）, excessive correction：l case （ 1 eye） ; group B ： cure ： 26 cases （ 36 eyes ）, insufficient correct ： 2 cases （ 2 eyes）, excessive correct： 2 case （2 eyes）. There was no difference in all rate between the both groups. All the cases underwent hypo-phasis in the early period after the operation, which recovered 3 months later. All the cases were without re- currence during the followed-up period. There were no abnormity of the upper limbus palpebralis, limbus palpebralis radian, catacleisis and muscular activity. Conclusion Front-alis muscle flap suspension opera- tion is an effective method of treating ptosis. However, the frontalis muscle flap suspension through behind lessens a skin incision than it, and has the characteristic of better effects, fewer complications and could a- chieve better cosmetic result.