中重度下颌瞬目综合征患者的手术治疗  

Surgical management of jaw winking synkinesis

作　　者：李冬梅[1] 陈涛[1] 郝磊[1] 侯志嘉[1] 

机构地区：[1]首都医科大学附属北京同仁医院眼科中心,100730

出　　处：《中华眼科医学杂志（电子版）》2012年第1期9-12,共4页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

摘　　要：目的 评估中重度下颌瞬目综合征的手术效果.方法 回顾性分析北京同仁医院2008年1月至2011年1月收治的中重度下颌瞬目综合征患者临床治疗资料,共11例11只眼,其中女性4例,男性7例,平均年龄7.2岁.中度下颌瞬目7例,重度下颌瞬目4例,伴中度上睑下垂4例,伴重度上睑下垂7例.对所有患者进行了患侧提上睑肌腱膜节段切除联合同侧额肌腱膜瓣悬吊术.结果 随访10~36个月,所有患者均有持续约6个月的睑裂闭合不全、上睑迟落及轻度双眼不对称,术后半年此症状逐渐好转.9例获得了满意效果,双眼对称,无明显上睑迟落和睑裂闭合不全.1例残存轻度欠矫,1例仍残存有小幅度(＜1 mm)下颌瞬目症状.结论 患侧提上睑肌腱膜节段联合同侧额肌腱膜瓣悬吊术矫正中重度下颌瞬目综合征可获得较好的美容效果,是中重度下颌瞬目综合征患者可以选择的手术方式.Objective To evaluate the clinical effectiveness in surgical management of jaw winking syndrome. Methods Eleven patients( four females and seven males with an average age of 7. 2 years) with jaw winking syndrome between 2008 and 2011 were retrospectively analyzed. Upper eyelid excursion was measured and graded. seven patients with moderate jaw winking( 3 ~ 5 mm) and others with severe jaw winking( ≥5 mm),while four patients with moderate ptosis( ≥3 mm) and seven patients with severe ptosis( ≥4 mm). All patients underwent segmental excision of the levator aponeurosis combined with ipsilateral frontalis suspension on the affected eye. Results Follow-up period ranged from 10 to 36 months. The surgical success was achieved in nine patients with desired appearance. Ptosis was undercorrected in one patient,and one patient still had mild jaw winking syndrome( < 1 mm). Complications included lid lag and lagophthalmos which would last about 6 months and a little asymmetry in both eyelids. Conclusions Levator disinsertion combined with ipsilateral frontalis suspension were effective in the treatment of jaw winking syndrome.

关 键 词：下颌疾病 眼睑下垂 眼睑成形术 

分 类 号：R779.6[医药卫生—眼科]