眉下缘切口提上睑肌肌膜瓣折叠、眼轮匝肌肌瓣悬吊术矫正上睑松弛

【作者】 李晓飞； 李成龙； 王金波； 余墨声；

【机构】 荆门市第二人民医院； 武汉大学人民医院；

【摘要】 目的:通过眉下缘切口提上睑肌肌膜瓣折叠、眼轮匝肌肌瓣悬吊术治疗中、重度上睑松弛伴眉下垂。方法:对眉下垂的上睑松弛患者,根据程度于眉下缘外侧2/3设计梭形切口,切除部分眉下皮肤,切除眼轮匝肌眶部,游离出眼轮匝肌肌瓣,折叠提上睑肌肌膜瓣连同眼轮匝肌肌瓣固定于眶缘骨膜上,眼轮匝肌肌瓣上缘悬吊于额肌上,上提并缝合上睑皮肤。结果:通过对41例上睑松弛患者行眉下缘切口提上睑肌肌膜瓣折叠、眼轮匝肌肌瓣悬吊双提升术,上睑松弛症状明显改善,眉部整体形态明显美观。结论:眉下缘切口提上睑肌肌膜瓣折叠、眼轮匝肌肌瓣悬吊双提升术对上睑松弛的治疗效果显著。手术操作简单,并发症少,切口隐蔽,值得临床推广。更多还原

【Abstract】 Objective:To investigate the anatomy of the inferior eyebrow region of the upper eyelid can show us the feasibility basis of double-elevating the levator palpebrae superioris and the flap of musculus orbicularis oculi via the sub -eyebrow incision to cure blepharochalasis.Method:1. Observing the tissue structure:nerve,vessels of the upper eyelid with 10 eye specimens from 5 fresh cadavers layer by layer.2.For those patients with blepharochalasis,we design fusiform incision in the lateral 2/3 portion along the sub-eyebrow to cut off part of the skin and pars orbitalis musculi orbicularis oculi,then free the flap of musculus orbicularis oculi.We fold levator palpebrae superioris and fix it to the periosteum on the orbital margin together with the flap of musculus orbicularis oculi.The upper margin of the musculus orbicularis oculi is fixed to the frontal muscle at the same time;finally finish the suture,all we do above can result in elevating the skin of the upper eyelid.Result: With performances of double -elevating the levator palpebrae superioris and the flap of the musculus orbicularis oculi via the incision along the sub-eyebrow in 21 patients who suffered the blepharochalasis,the symptom of relaxation obviously release as well as beautiful outlook of the whole figure in the eyebrow.Conclusion:Double-elevated operation of the levator palpebrae superioris and the flap of the musculus orbicularis oculi via the incision along the sub-eyebrow can perfectly cure blepharochalasis. The procedure is simple,with few complications and masking incision,so it deserves to be generalized in the clinical practice.更多还原