传统前徙步骤的附加技术矫正重度上睑下垂__培训课件.pptxVIP

Adjunctive Techniques to Traditional Advancement Procedures for treating Severe BlepharoptosisShi HengBRAVOU Aesthetic Plastic Hospital Plastic and Reconstructive Surgery April 2014Volume 133, Number 4BackgroundTo create a more physiologic（生理性的） eyelid opening in patients with severe blepharoptosis (睑下垂), the authors used lamina propria mucosa of conjunctiva（结膜的睑板固有粘膜）, which continues to the check ligament of the superior fornix (上穹窿的check韧带), in addition to levator aponeurosis and Müller’s muscle as a composite flap. In patients with epicanthal folds（内眦赘皮） with associated telecanthus（内眦间距过大）, the authors also performed epicanthoplasty with medial canthal tendon shortening.1. Superior rectus muscle.2. Levator muscle. 3. Conjoining of SRMwith levator muscle sheath. 4. Tenons capsule. 5. Suspensory ligament of superior fornix.6. Whitnalls ligament. 7. Frontalismuscle. 8. Brow fat pad. 9. Orbital orbicularis. 10. Arcus marginalis. 11. Orbital septum. 12. Preaponeurotic fat pad. 13. Preseptal orbicularis. 14. Postorbicularis fascia. 15. Levator aponeurosis. 16. Superior conjunctival fornix. 17. Müllers muscle. 18.Conjunctiva. 19. Superior tarsus. 20. Pretarsal orbicularis.腱膜前脂肪 Pre-aponeurotic fat眶隔前脂肪 Pre-septal fat睑板前脂肪 Pretarsal fat眼轮匝肌下脂肪 retro-orbicularis oculi fat (ROOF) sub-orbicularis oculi fat (SOOF)Methods Fifty blepharoptosis patients (85 eyelids) with a degree of ptosis of greater than 4 mm underwent the advancement technique using the levator aponeurosis–Müller’s muscle–lamina propria mucosa of conjunctiva as a composite flap. Twenty-one (42 percent) of those patients also underwent split V-W epicanthoplasty and plication of the medial canthal tendon for epicanthal folds with associated telecanthus. Degree of ptosis and levator function were measured preoperatively and postoperatively.Results Complete or near-complete correction of ptosis (degree of ptosis,1 mm) was achieved in 54 eyelids (63.5 percent) and mild residual ptosis轻度残余下垂 (degree of ptos