额肌筋膜瓣悬吊治疗上睑下垂的技术改进  

The impovement of using frontalis-aponeurosis suspension to correct ptosis

作　　者：宫昔愿[1] 周兴亮[1] 郭丹凤[1] 马继任[1] 何茂文[1] 

机构地区：[1]济南市中心医院整形外科,250013

出　　处：《中华医学美容杂志》2000年第5期250-251,共2页

摘　　要：目的　为了避免术中损伤眶上神经、血管和面神经颞支的危险 ,以及在调整额肌筋膜瓣张力时反复拆除并重新缝合与睑板的固定线之弊端。方法　对 12 6例上睑下垂患者采用了技术改进后的额肌筋膜瓣悬吊法 ,在术中仅将额肌筋膜与皮下组织充分游离 ,在眶上缘下方切断额肌筋膜后 ,由骨膜面上直接向下推进与睑板上缘缝合固定 ,然后在其切口两端向上剪开 3～ 5mm ,调整其张力适度为止。结果　 12 6例患者 ,经 6个月～ 10年的随访 ,无 1例复发 ,效果良好。结论　该法与传统术式相比 ,可明显减轻额部及上睑组织的损伤 ,增强额肌筋膜提上睑的能力 ,而无损伤神经、血管之忧。手术操作更趋简便 ,且安全可靠。Objective In order to protect the supraorbital neurovessels and the branches of facial nerve and avoid the disadvantages of adjusting the tension of the flap by suturing and removing repeatedly.Methods Using improved operative procedure and techniques, we only dissected the frontalis-aponerosis and the skin completely, cut the frontalis-aponeurosis under the margin of orbital and pulled down on the superficies of periosteam, fixed it to the upper margin of the tarsal plate by mattress sutures. The flap was split at both sides of the incision about 3～5 mm with the tension being adjusted to moderate degree. Results 126 cases of ptosis have been treated with this method. The patients were followed up from 6 months to 10 years with satisfied results and no recurrence.Conclusion Compared with traditional methods, this improved technique decreases the damage to upper lid and frontalis area without the risk of damaging the vessels and nerves. It also strengthens the ability of the frontalis-aponeurosis in lifting upper lid, it is safe and simple.

关 键 词：眼睑下垂 额肌筋膜瓣 技术改进 悬吊术 

分 类 号：R622[医药卫生—整形外科]