改良鼻侧缝合点缩短内眦韧带矫正重度内眦赘皮.docVIP

改良鼻侧缝合点缩短内眦韧带矫正重度内眦赘皮[摘要 ]目的:探讨重度内眦赘皮矫正术的手术要点,旨在尽量减少术后赘皮复发,缩短瘢痕恢复时间。方法:将内眦部横行切口延长至下睑缘内侧,通过此切口,彻底松解局部错构的眼轮匝肌,充分暴露内眦韧带前支鼻侧骨膜隆突止点,将其与内眦韧带起点缝合,折叠缩短内眦韧带,矫正重度内眦赘皮,同时完成重睑成形术。结果:2004年9月～2009年6月临床应用28例,其中25例得到半年以上随访,内眦赘皮矫正效果良好,切口瘢痕恢复快,重睑形态自然。结论:采用改良鼻侧缝合点折叠缩短内眦韧带,结合松解错构的眼轮匝肌矫正重度内眦赘皮,同期行重睑成形术,手术效果明显、稳定,患者满意度高。 [关键词]内眦赘皮矫正;内眦韧带缩短;重睑成形术 [中图分类号]R622[文献标识码]A[文章编号]1008-6455(2010)06-0838-02 Correction of the epicanthal using inverted L-shape incision and canthal ligment ZHOU Li-ping,ZHANG Zhi-hua,LI Yan,LIU Guo,KONG Xiang-hong,ZHANG Wen-hao,CHU Hai-han,ZHANG Hong-tu,LI Xi-rong (Department of Burns and Plastic Surgery, First People’s Hospital of Jining, Jining 272100,Shandong,China) Abstract:Objective To explore the key point of correction method for severe epicanthus to shorten the recover time of scar after operation.MethodsThe transverse incision in the inner canthus was extended to lower eyelid margin, through this incision, dislocated orbicularis oculi muscle near medial canthal ligament was completely released and the attachment of medial canthal ligament on the nasal periosteum was fully exposed, then medial canthal ligment was folded to correct severe epicanthus, meanwhile upper eyelid fold formation was made at the same time.ResultsTwenty eight patients were treated with this method from September 2004 to June 2009 and 25 cases were followed up for more than 6 months. They showed good epicanthus correction results with short scar recover time and natural double eyelid appearance.ConclusionThe use of improved nasal suture point canthal ligament shortening combined with the release of dislocated orbicularis oculimuscle and simultaneous doubled eyelid formation, which led to stable effect of operation and improved the satisfaction of patients. Key words:epicanthoplasty; canthal ligament; construction of double eyelid 内眦赘皮在东方民族中比较普遍,多属先天性,并有一定的遗传倾向。据统计,在亚洲人群中其发生率约50%,而在单睑人群中其发生率超过70%[1]。对于合并重度内眦赘皮的单睑患者,在行重睑成形术时,如果不矫正内眦赘皮,会因赘皮遮盖而成为“内双”,有碍眼部外形美观[2],亦影响重睑成形手