上睑提肌腱膜瓣与额肌瓣悬吊缝合矫正重度上睑下垂

目的：为克服单纯额肌瓣悬吊治疗重度上睑下垂存在的缺点，更好地保持眼睑的原有结构，使矫治后的眼睑符合其生理和生物力学特点。方法：在患侧分别形成额肌瓣和上睑提肌腱膜瓣，将两瓣相互重叠缝合固定，起到悬吊上睑、矫正下垂畸形的作用。结果：利用该方法对46例52侧重度上睑下垂的眼睑进行了治疗，随访患者24例，28侧眼睑，其中23侧眼睑取得了较满意的治疗效果，患睑睁大时额肌收缩两侧眼裂大小基本对称，可达到正常睑缘的位置。睑缘弧度及重睑线外形满意。5侧眼睑矫正不完全，仍有一定程度的下垂。结论：术者认为利用无功能的上睑提肌形成腱膜瓣与传统的额肌瓣重叠悬吊缝合，保持了眼睑的原有结构，具有上睑悬吊牢固、不易复发、睑缘和重睑线弧度及外观满意的优点，对畸形矫正效果良好，优于传统的单纯额肌悬吊术。

Correction of complete blepharoptosis with suspension by frontalis muscle flap and levator palpebrae superior aponeurosis flap

Objective: To improve the operation of frontalis muscle suspension for treatment of blepharoptosis. Methods: Frontalis muscle flap and levator palpebrae superior aponeurosis flap were formed in the frontal part and upper eyelid. The two flaps were overlapping sutured to suspend the upper eyelid and correct blepharoptosis. Results: The operation was performed on 52 eyelids of 46 patients, 28 eyelids of 24 patients were followed -up after operation. Satisfactory results were achieved in 23 eyelids , the palpebral margins were in the normal position and its shape were nature ,only 5 eyelids were corrected not completely, no ectropion and other complications were occurred. Conclusion: Frontalis muscle flap and levator palpebrae superior aponeurosis flap overlapping sutured suspension is an effectiveness and safe operation for complete blepharoptosis.