摘要
目的 根据内眦赘皮(epicanthus)的解剖学成因设计一种新的内眦角成形术式(epi-canthoplasty)，以提高重睑成形术的效果，克服通常手术方法的易复发性和易在内眦区形成明显瘢痕的弊端。方法 根据常见的形成内眦赘皮的解剖学原因，设计睑缘切口内眦赘皮改形新术式：通过内眦上下睑缘切口，将内眦赘皮与眼轮匝肌及内眦韧带浅头充分游离，去除异位内眦韧带浅头和增厚的眼轮匝肌后，重新形成内眦角，修剪多余皮肤后，缝合上睑缘切口。对患者术后伤口进行愈合观察，内眦部分7天拆线，3－12月进行术后随访，观察内眦角形态及重睑效果。结果 本研究应用新术式矫治内眦赘皮122例，术中仔细观察内眦韧带与眼轮匝肌位置关系，按解剖学分类标准加以记录。122例内眦赘皮包括：上睑型67例（54.9%）、睑板型51例（41.8%）、反向型4例（3.3%），未发现眉型。术后无感染及其它并发症的出现，随访结果：内眦赘皮矫治效果满意，未出现内眦赘皮复发且手术后切口痕迹隐蔽。结论 睑缘切口内眦赘皮改形术设计灵活、操作简单，矫治效果满意，适合各种类型内眦赘皮，值得进一步推广。
Objective According the anatomical factors of epicanthus, to design a new epicanthoplasty , In order to improve the effect of double-eyelidplasty, and to conquer the abuse of scar and recrudescence. Method To statistic analyse the rate of anatomy sorts what patients did epicanthoplasty from 2005—2009. To design a new epicanthoplasty when we did double-eyelidplasty. First, through upper and lower palpebral margin incisions, thoroughly released and excised the connective and orbicularis oculi muscle dense fibers underlying epicanthal folds as well as the superficial head of medial canthal ligament. Second, repositionning the medial canthus in double eyelidplastic procedure, cut off the redundant skin tissue and closed the incisions. Results 122 epicanthoplasties had been performed during the past 4 years. We observed the position relation of epicanthic ligament and eyemuscle and recorded it according to the anatomic sorts in the operation. Then we did three sorts totally, one is upper tarsi type [UTT]54%, other is tarsi type [TT]42%, another is reverse tarsi type [RTT] 4%, no eye-brown type. Follow-up time ranged from 3 to 12 months. Postsugery scars were invisible in all cases. All patients were satisfied with operation results. No recurrence of epicanthal fold was observed. Conclusion The introduced method has advantages in avoiding scar formation and is especially a suitable approach for epicanthoplasty in Asian patients.
引文
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