自体阔筋膜移植联合钛板钛钉内固定矫正难治性内眦畸形

目的评价自体阔筋膜移植联合钛板钛钉钢丝内固定矫正难治性内眦畸形的手术效果。设计回顾性病例系列。研究对象8例难治性内眦畸形患者,车祸伤6例,砂轮击伤1例,泪囊肿物摘除术后1例。其中2例为内眦畸形矫正术后再次复发者。方法采用自体大腿阔筋膜,将其一端缝合固定于内眦角深部组织即相当于内眦韧带残端处,另一端在泪前嵴保存完好的患者中,通过钢丝、钛钉固定于泪前嵴上,在泪前嵴和鼻骨破坏明显的患者中,通过钢丝、钛板、钛钉固定于深部稳定性较强的骨质上。主要指标双眼内眦与鼻中线间距,外观是否对称。结果8例患者术后内眦畸形明显矫正,外观显著改善,随诊6～12个月效果持续稳定。结论自体阔筋膜移植联合钛板钛钉钢丝内固定矫正难治性内眦畸形效果良好,可以有效预防复发。

Treatment of refractory inner canthus deformity using autologous fascia combined with titanium plate and titanium nail

Objective To evaluate the therapeutic effects of using femoral fascia combining with titanium plate and titanium nail in the treatment of refractory inner canthus deformity. Design Retrospective case series. Participants 8 cases (8 eyes) with refractory inner canthus deformity, 6 cases with traffic injury, 1 case with blunt injury, 1 case with lacrimal sac tumor resection, 2 cases with postoperative recurrent inner canthus deformity. Methods Femoral fascia was applied, one side was affixed at deeper tissue of inner canthus (terminal inner canthus ligament). For patients with normal anterior lacrimal crests, the other side of femoral fascia was affixed at the anterior lacrimal crest; for the patient with damaged anterior lacrimal crest and nasal bone, the other side of fascia was affixed at the deeper and solid bone. Main Outcome Measures The distance between inner canthi and nasal septum. Results All the 8 eyes have significant improved appearances postoperatively, and at the 6~12 months follow-up periods, postoperative effects were satisfactory. Conclusions In the treatment of refractory inner canthus deformity, using autologous fascia combined with titanium plate and titanium nail is effective and can prevent recurrence.