肌皮瓣法结合下睑缘楔形切除矫治老年性下睑袋.docVIP

肌皮瓣法结合下睑缘楔形切除矫治老年性下睑袋[摘要]目的：探讨老年性下睑袋的手术矫正方法。方法：应用Hill试验、下睑牵拉试验、内眦韧带松弛试验和外眦韧带松弛试验检测患者下睑支持结构的松弛情况，采用肌皮瓣法下睑袋整复术结合下睑缘楔形切除进行治疗并长期随访。结果：本组患者共41人，均为老年性下睑袋患者，其中男性15例，年龄为42～67岁，女性26例，年龄为53～65岁；下睑板松弛34例，内眦韧带松弛7例。术后有17例患者接受了长期随访，随访时间为7～26个月（平均12.7月）。下睑缘均平整，无下睑退缩，术后效果良好。结论：应用肌皮瓣法结合下睑缘楔形切除治疗伴有下睑支持结构松弛的老年性下睑袋是有效而简单的方法，但对外眦韧带松弛者慎用。 [关键词]下睑袋；下睑支持结构；下睑缘楔形切除术 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2008）05-03 The treatment of the lower palpebral bag with myocutaneous flap lower eyelid blepharoplasty combined with wedged excision of the palpebral margin YU Hao, ZHANG Hai-ming, FENG Yue-jian, SHI Jun, ZHONG Ya-ni, HAN Xin-ming, JIN Hai-lan, GUI Lai (Plastic and Cosmetic Surgery Center of Head and Neck, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing 100144, China) Abstract：ObjectiveTo find the effective procedures on treating the aged lower palpebral bag.MethodsPreoperatively, the Hill test, the snap test, the relaxing tests of the medial and lateral canthal tendons were used to find the condition of the support structures. The myocutaneous flap lower eyelid blepharoplasty combined with wedged excision of the palpebral margin was applied to treat the aged lower eyelid deformities.Results41 patients were treated in this group and 17 patients were followed up in long-term period. The follow-up time was 7 to 26 months (average, 12.7 months). The lower eyelid margins were smooth and there was no lower eyelid retraction.ConclusionThe myocutaneous flap lower eyelid blepharoplasty combined with wedged excision of the palpebral margin technique was effective and simple. Key words:aged lower eyelid deformities； support structures of the lower eyelid；wedged excision of the palpebral margin 下睑组织结构的老年性改变除了皮肤皱纹、眼轮匝肌变薄和眶脂肪外突外，另一个重要的特征是下睑支持结构松弛，其临床表现为睑缘下移，角膜下缘外露和巩膜外露过多。如果术前不及时发现，当行下睑袋整复术后，因局部组织的水肿或重力等因素，会出现不同程度的睑球分离，严重者下睑外翻，影响手术效果。1999年～2007年我们治疗了41例老年性严重下睑袋伴有下睑支持结构松弛的患者，采用肌皮瓣法结合下睑缘楔形切除下睑袋整复术，收到了良好的效果。 1临床资料 本组共41例，均为老年性下睑袋患者，其中男性15例，年龄为42～67岁；女性26例，年龄为