提上睑肌断离+额肌瓣悬吊联合手术治疗下颌瞬目综合征11例  

Levator excision and frontalis suspension to treat Marcus-Gunn jaw-winking syndrome(11 cases report)

作　　者：张士玺[1] 张华[1] 王鸿[1] 

机构地区：[1]山东大学附属省立医院眼科,山东济南250021

出　　处：《山东大学耳鼻喉眼学报》2014年第5期68-71,共4页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨利用"提上睑肌断离+额肌瓣悬吊"方法手术治疗下颌瞬目综合征的临床疗效。方法采用"提上睑肌断离+额肌瓣悬吊"的方法,治疗下颌瞬目综合征患者11例(11眼),11例均表现为上睑下垂,并且当患者张口、下颌移向健侧或向前移动时下垂的上睑可突然提起,甚至超过对侧。结果本组患者疗效良好,双眼睑缘高度基本一致,开闭口或移动下颌时上眼睑缘位置无变化;睑缘弧度自然,无畸形;术后有不同程度的眼睑闭合不全和不能瞬目。结论下颌瞬目综合征有其典型的临床特点,但其体征隐蔽,需在动态下观察。检查不够仔细的情况下会误诊为单纯的上睑下垂,从而造成误诊误治;提上睑肌断离+额肌瓣悬吊操作简单、效果良好,并发症少。Objective To explore the clinical effectiveness of levator excision and frontalis suspension in the treatment of Marcus-Gunn jaw-winking syndrome.Methods 1 1 cases （1 1 eyes）of Marcus-Gunn jaw-winking syndrome received surgical treatment of levator excision and frontalis suspension.All patients presented ptosis,and when the patients opened mouth,jaw moved toward the healthy side or moved forward,the saggy eyelid would rise suddenly even more than the contralateral eye.Results All patients had good curative effect.Binocular palpebral fissure height was symmetrical and all eyelids showed complete resolution of jaw-winking.The upper palpebral margin was natural.Some patients presented incomplete eyelid closure and winking to some extent.Conclusion Marcus-Gunn jaw-winking syndrome presents typical clinical features but not obvious signs.Dynamic observation is necessary to achieve the diagnosis.Without careful examination,its very easy to be misdiagnosed as simple ptosis,which will lead to inappropriate treatment.Levator excision and frontalis suspension is a feasible surgical approach to treat Marcus-Gunn jaw-winking syndrome.

关 键 词：下颌瞬目综合征 上睑下垂 额肌瓣悬吊 

分 类 号：R777.1[医药卫生—眼科]