内眦角及重睑皱褶双入路内眦赘皮整形术.doc

内眦角及重睑皱褶双入路内眦赘皮整形术[摘要]目的：探讨和改进内眦赘皮整形术式，使术后内眦角瘢痕隐蔽，眼裂增大，内眦赘皮消失，眼型美观自然。方法：在新内眦点处设计一小横切口，而重睑切口近内眦与横切口不贯通，保留切口之间的皮肤5～4mm，充分离断或去除部分眼轮匝肌、内眦韧带内向固定，切口经张力变形转向后，去除下部多余的三角形皮肤，将两切口间保留的皮肤整理埋入重睑皱褶内。 结果：本组256例，经3个月到2年对186例的随访，术后内眦部均无明显瘢痕，眼裂增长内眦赘皮消失、内眦角暴露。16例内眦角轻度欠对称，考虑与内眦韧带内向固定的程度有差异相关。讨论：表皮间断切口保留了内眦角上缘的皮肤完整，减少了瘢痕的增生可能，是较安全的内眦整形术式。 [关键词]内眦；内眦韧带；重睑术；瘢痕 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2007）11-1513-03 A New mathod of Epicantholplasty by Two incisions of eyelid fold and canthus YU Jing-tian,LI Bin (Department of Plastic Surgery,Shanghai Time Plastic Hospital,Shanghai 200021,China) Abstract:ObjectiveTo explore a more safe and simple method of epicantholplastyfor not only correcting epicanthus successfully but also leaving no scar or minimal scar.MethodsDesign two incisions at canthus, one is short and horizontal just at the new point of canthus, the other is along eyelid fold about 5～4mm away from the short one. Transverse the horizontal incision into vertical by breaking or excising fibromuscular band under epicanthal skin and fixing canthus ligment on the lateral nasal aponeurosis. Remove lower dog ear and rearrange upper skin into double eyelid fold. Results256 cases were treated with the method. After 3 to 24months follow-up in 186 cases，all of them showed good eye shape，epicanthus disappeared andno scar or light scar hyperplasia at canthus.ConclusionBecause of not being cut integrated during the procedure, skin of canthus has little dangerous of scar hyperplasia. This technique is a simple and reliable surgical approach for correction of epithanthus. Key words: epicanthus；canthal ligament；double eyelidplasty； minimal scar 内眦赘皮、单上睑是东方人所特有的眼睑解剖特征。我们对重睑术受术者检查，发现他们不同程度的存在：上睑丰满、眼裂较短、内眦距较宽，单睑及各种类型的内眦赘皮等症状。只有联合行内眦赘皮整形才能使重睑术后的眼形更加自然美丽。为了避免术后内眦部瘢痕的增生，自2005年3月～2007年3月我们采用内眦角――重睑皱褶双入路内眦赘皮整形术对256例中轻度内眦赘皮求美者施行整形术，对186例在术后3～24个月随访发现，术后内眦瘢痕极隐蔽，眼裂增长，内眦赘皮消失，眼形美观自然，效果满意，现介绍如下。 １临床资料 本组256例，女性244例，男性12例，年龄16～43岁。均为中轻度内眦赘皮，非小眼症或外伤瘢痕等较严重的内眦赘皮。分AB两组；A组为单睑组：209例内眦整形与重睑术同