睑缘切口结合鼻侧腱膜固定在内眦赘皮矫正中应用.docVIP

睑缘切口结合鼻侧腱膜固定在内眦赘皮矫正中应用[摘要] 目的：探讨一种有效且能减轻切口瘢痕增生的内眦赘皮矫正方法。方法：通过睑缘切口将内眦赘皮皮下筋膜、内眦韧带及眼轮匝肌肌纤维充分松解、分离，把内眦赘皮向鼻侧腱膜推移，并将内眦赘皮皮下包括部分真皮缝合固定在鼻侧腱膜上。结果：进行手术者52例，经6个月～2年随访，眼裂变长，眼型自然美观，未有复发和明显瘢痕。结论：该方法设计简单，操作容易，术后瘢痕不明显，是矫正内眦赘皮较理想的方法。 [关键词] 内眦赘皮；睑缘切口；鼻侧腱膜固定 [中图分类号] R771 [文献标识码]B[文章编号]1673-7210（2010）11（b）-148-02 Incision of palpebral margin with fixation of latefal nasal aponeurosis: the aplication of epicanthus correction XU Heng (Department of Ophthamology, the Fourth People’s Hospital of Zhenjiang, Jiangsu Province, Zhenjiang 212003, China) [Abstract] Objective: To discuss an effective methods of epicanthoplasty that can decrease the scar hyperplasia agter the procedure. Methods: Through an incison of palpebral margin, the canthal ligament of subcutaneous fascia and muscle fibers of orbicularis could be loosened and separated as far as possible. The epicanthus could be pushed towards to lateral nasal aponeurosis, so subcutaneous tissue including partial corium of epicanthus were then sutured and fixed to lateral nasal aponeurosis. Results: 52 case obtained satisfied effects after epicanthoplasty. After 6 months to 2 years follow-up, the patients’ palpebral fissure became longer. The rebuild canthus was with nature contour and no recrudescence and scars. Conclusion: This method is a simple and easy technique with inconspicuous postoperative scars. It is an ideal technique for correction of epicanthus. [Key words] Epicanthus; Incision of palpebral margin; Fixation of latefal nasal aponeurosis 内眦赘皮是存在于亚裔人种中的常见眼睑类型。内眦赘皮使得眼裂显小，影响了眼部的美观，同时也影响重睑成形的术后效果[1]。正常人眼轮匝肌完全止于内眦韧带，而内眦赘皮者除了部分正常止于内眦韧带，其余部分止于眼前脊或下睑处轮匝肌，形成蹼状肌束，是形成内眦赘皮的原因。同时，鼻背低平，内眦部位皮肤水平方向过剩，垂直方向不足，也是内眦赘皮的主要原因[2]。笔者采用睑缘切口结合鼻侧腱膜固定术，对于2008年1月～2009年1月收治的52例内眦赘皮进行手术治疗，该方法手术设计简单，操作方便，手术时间短，术后瘢痕不明显，效果令医患满意，现报道如下： 1 资料与方法 1.1 一般资料 本组患者52例，男性2例，女性50例；年龄19～41岁；均为先天性内眦赘皮患者，睑板型41例，睑型5例，倒向型6例，其中46例与重睑同时进行手术。 1.2 手术方法 1.2.1 手术设计患者平卧于手术台上，手术者用拇指将内眦皮肤向鼻侧推压，观察内眦移动的位置和泪阜的显露情况，结合面部外观，观察推压后的面部外观效果。放开拇指，使内眦皮肤自然复位，用龙胆紫