全麻下额肌瓣悬吊术治疗学龄前儿童先天性上睑下垂.doc

全麻下额肌瓣悬吊术治疗学龄前儿童先天性上睑下垂[摘要]目的：探讨全麻下额肌瓣悬吊术治疗学龄前儿童先天性上睑下垂的有效手术技巧。方法：在全麻下，对26例患者32 只眼上睑下垂应用额肌瓣悬吊术予以矫治，术中将患侧上睑缘中央点上提到角膜上缘上1mm，外侧固定点的高度略高于中央点。结果：术后7天拆线后，26例患者32 眼均有程度不等的睑裂闭合不全。术后随访17个患者19只眼，随访时间为6～16个月。Ⅰ级（良好）12只眼：上睑下垂矫正满意，重睑皱襞自然美观，睑缘位置、弧度形态比较理想，两侧对称，无明显睑裂闭合不全。Ⅱ级（尚好）7只眼：上睑下垂较术前有明显改善。结论：学龄前儿童可以在全麻下应用额肌瓣悬吊术的方法来矫正上睑下垂，手术关键是将患侧上睑缘上提到角膜上缘上1.5mm以上，外侧固定点的高度略高于中央点。 [关键词]学龄前儿童；上睑下垂；额肌瓣悬吊术；全麻 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2008）08-1151-03 Treatment for the blepharoptosis of the pre-school children with the suspension of frontal muscle flap in general anesthesia HOU Dian-ju,FANG Lin,GUO Xin,WANG Jia-qi (The Center of Face and Heck, Plastic Surgery Hospital of Peking Union Medical College,Beijing 100144,China) Abstract:ObjectiveTo discuss technique and skill about suspension of frontal muscle flap in order to correct congenital blepharoptosis in pre-school children under general anesthesia.MethodsUnder general anesthesia, 32 eyelids of 26 children were cured by suspension of frontal muscle flap. Middle point of the upper edge of the eyelid was raised 1 millimeter higher than the upper edge of the cornea. The lateral point was fixed a little higher than the middle fixing point was done.ResultsThe sutures were removed seven days after surgeries. Different lagopthalmus happened in 32 eyelids of 26 children with no eyesight problem. Nineteen eyes of seventeen patients were followed up for 6 to 16 months. Fifteeneyes were good eyesight and appearances. The patients were satisfied with the results. The curve of eyelid edges in four eyes was not natural. But the patients felt acceptable. Lagopthalmus of 14 eyes disappeared. Lagopthalmus of 1 to 2 mm occurred in five eyes, No blepharoptosis relapse was observed.ConclusionCongenital blepharoptosis in pre-school children can be crued by suspension of frontal muscle flap under general anesthesia. The key point is to raise the upper edge of the eyelid 1 millimeter higher than the upper edge of the cornea and to fix the late