延伸下睑缘切口的上拱形瓣内眦赘皮矫正术  

Modified epicanthoplasty combining upper arch flap and extended incision of lower eyelid

作　　者：张颂[1] 薛红宇[1] Zhang Song;Xue Hongyu(Department of Plastic Surgery,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院成形科,100191

出　　处：《中华整形外科杂志》2020年第7期797-801,共5页Chinese Journal of Plastic Surgery

摘　　要：目的探索一种简便有效,且切口瘢痕不明显的内眦赘皮矫正术式,评价其临床效果。方法统计分析2011年12月至2018年6月北京大学第三医院成形科收治的内眦赘皮患者687例,女664例,男23例,年龄17~55岁,平均28岁。以使新的内眦间距与新形成的睑裂宽度相近的原则在赘皮表面设定新的内眦点,沿重睑线至新内眦点做延长线,水平牵拉展平内眦部皮肤,由实际内眦点向上述延长线连线,形成一顶端指向头侧的拱形瓣,沿此拱形瓣及下睑睫毛下方全层切开皮肤,剥离、剪断跨越内眦韧带的眼轮匝肌束,对内眦处皮肤进行修薄,于下睑缘皮下进行充分剥离减张,缝合新内眦点与原实际内眦点,其余皮肤妥善对位缝合。缝合完成后,即刻于术区行类固醇类药物的局部注射。结果随访687例患者,术后均睑裂变长,内眦间距缩短,赘皮无复发。其中3.49%(24/687)的患者存在下睑切口上下切缘厚薄不均,8.15%(16/687)存在原拱形瓣皮肤较余处肤色稍浅。切口瘢痕于术后6个月后均不明显,患者对手术效果均基本满意。结论延伸下睑缘切口的上拱形瓣内眦赘皮矫正术充分矫正了内眦赘皮及其对眼部外形的影响,手术设计简便,矫正术后效果稳定,切口隐蔽,瘢痕不明显,患者满意度普遍高。Objective To explore a simple and effective surgical technique for epicanthus correction that enables postoperative epicanthus elimination with an inconspicuous incision scar,and to perform a comprehensive assessment of the postoperative effects.Methods A new medial canthus was established on the surface of the epicanthus based on the principle that the new inner canthal distance and the new palpebral fissure length should be approximately equal,and an extension line was made along the supratarsal crease to the new medial canthus.Subsequently,the skin at the medial canthus was flattened by horizontal traction,and a line was drawn from the actual medial canthus to join the aforementioned extension line,thereby forming an arch with its apex pointing towards the top of the head.A full incision was then made along the arch and the area under the lower eyelashes.The orbicularis oculi muscle bundles that passed above the medial canthal ligament were detached and cut,the skin at the medial canthus was thinned,and adequate detachment and decompression were performed subcutaneously at the inferior palpebral margin.Lastly,the new and original medial canthi were sutured together,while the remaining skin was sutured into position.After suturing had been completed,local injection of steroids was immediately performed in the operative area.Results Follow-up was conducted in a total of 687 patients who were treated using this technique.Postoperatively,elongated palpebral fissures,shorter inner canthal distances,and no recurrences of epicanthus were observed in all patients.Uneven thicknesses in the superior and inferior margins of the lower eyelid incision was found in 3.49%of the patients,while a lighter skin color in the original arch flap compared with other skin areas was observed in 8.15%of the patients.6 months postoperatively,the incision scars were inconspicuous in all patients,and most patients were satisfied with the effects of the surgery.Conclusions The modified epicanthoplasty technique involving the combination of

关 键 词：内眦赘皮 内眦赘皮矫正术 

分 类 号：R779.6[医药卫生—眼科]