内眦韧带复位固定术后失败原因分析  

Analysing the reasons for failure after medial canthal ligament reduction

作　　者：董冰松[1] 熊柯[1] 黄发明[1] 杨娟[1] 宗建华[1] 

机构地区：[1]南方医科大学南方医院眼科,广东广州510515

出　　处：《中国美容医学》2012年第7期1141-1142,共2页Chinese Journal of Aesthetic Medicine

摘　　要：目的:分析内眦韧带复位固定术后失败的原因,完善手术方法,以便在术中处理影响手术效果的因素,提高手术的成功率,改善术后效果。方法:对38例内眦韧带断裂致内眦移位畸形的患者行内眦韧带断端经鼻骨固定术、内眦韧带断端端端吻合术及内眦韧带断端鼻侧深部骨膜固定术。结果:内眦韧带复位固定术后内眦复位23例,改善4例,失败11例(其中8例为开始开展此术时发生)。效果不佳表现:眶鼻角不对称;内眦至鼻中线距离过宽;内眦角高度与对侧不对称。结论:术失败原因:钢丝断裂、眦韧带断端撕脱、局部瘢痕过度挛缩牵拉、鼻侧骨孔位置不准确、眶部鼻骨损伤畸形严重、受伤时间过长睑板挛缩。其中前五种原因可在术中处理,后两种原因目前难以解决。全面掌握内眦韧带复位固定术失败原因并在术中给予解决可以提高手术成功率。Objective Analysing the reasons for failure after the medial canthal ligament reduction for imProving success rate of the surgery thruogh solving the influence factors in the surgery. Methods We applied three methods on 38 patients that the medial canthal ligament were breaken.They were：reduction of the medial canthal ligament cut end by the fixation on the nasal bone,the cut end anastomosis of the medial canthal ligament,and the medial canthal ligament cut end fixation on the deep nasal periosteum. Results The medial canthal ligament Successful reset after the reduction in 23 cases,improving 4 cases,failure 11 patients （ 8 cases happened in the initail stage of this operation）. The bad effects include orbital nasal horn asymmetry,the angular distance to the center line is too wide,the angular angle and height of the asymmetry. Conclusion The reasons for failure after the medial canthal ligament reduction include the steel wire fracture,the avulsing of the angular ligament cut ends,the excessive stretch of local scar contracture,the position of nasal bone holes is not accurate,the orbit serious damage of nasal bone,the injury time is too long and the eyelid board contracture. The first five deformities can be corrected in the perioperative treatment,the other two deformities are difficult to solve.A comprehensive grasp of the angular ligament reset fixation and correcting the reasons for failure in the operation can improve the success rate.

关 键 词：内眦韧带 复位术 失败原因 

分 类 号：R622[医药卫生—整形外科]