眼轮匝肌肌皮瓣V-Y成形术修复内眦过大畸形  

The V-Y plasty of orbicularis oculi myocutaneous flap to repair the excessive inner canthus deformity

作　　者：潘贰 王布霖 于建刚 张胜昌 Pan Er;Wang Bulin;Yu Jiangang;Zhang Shengchang(Department of Aesthetic Plastic Surgery,Guangzhou Eye-Nose-Face Aesthetic Plastic Surgery Hospital Guangzhou 510630,China)

机构地区：[1]广州颜美荟医疗美容门诊部,广州510630

出　　处：《中华整形外科杂志》2022年第11期1283-1288,共6页Chinese Journal of Plastic Surgery

摘　　要：目的探讨眼轮匝肌肌皮瓣V-Y成形术修复内眦过大畸形的临床效果。方法回顾性分析2018年7月至2021年6月, 广州颜美荟医疗美容门诊部采用眼轮匝肌肌皮瓣V-Y成形术修复内眦过大畸形患者的临床资料。手术按术前设计在眼轮匝肌下剥离, 切口两侧均形成眼轮匝肌肌皮瓣, 靠内侧的肌皮瓣自行回退做为重建的赘皮;将外侧肌皮瓣V-Y推进在新内眦点固定后, 再分层将眼轮匝肌和皮肤V-Y对位缝合。术后随访内眦缩小程度、内眦赘皮外形、切口瘢痕和患者满意度。所有患者均在术前及术后6个月复查时测量内眦角间距, 采用配对t检验进行统计学分析, P<0.05为差异有统计学意义。结果共纳入83例患者, 女81例, 男2例, 平均年龄28岁(19~56岁)。术后所有患者均获3个月至2年随访, 平均1年, 术前存在的泪阜过度暴露明显缩小, 双侧内眦不对称性差异缩小, 内眦赘皮外形恢复自然, 切口瘢痕外观不明显;患者满意度评价:非常满意29例, 满意45例, 较不满意5例, 不满意4例。4例不满意患者中, 2例矫正不足, 术后6个月予以重新手术获得满意效果;1例过度矫正导致睑裂横径变小, 再次接受内眦赘皮矫正术得以改善;1例术后次日后悔眼角缩小, 强烈要求拆除复原。术前测量患者的内眦角间距为(28.8~38.0) mm, 平均(33.6±3.3) mm, 术后为(32.2~41.5) mm, 平均(37.5±2.9) mm, 术后较术前平均增加了3.9 mm,差异具有统计学意义(t=-15.78, P<0.001)。结论眼轮匝肌肌皮瓣V-Y成形术适用于内眦赘皮矫正术后内眦过大畸形的修复, 设计思路简便, 术后效果稳定, 患者满意度较高。Objective To explore the clinical effect of the V-Y plasty of musculocutaneous flap in repairing the excessive width of inner canthus deformity.Methods Retrospective analysis was performed between July 2018 and June 2021 in patients treated with this method.V-Y design along the inner corner of the eye before operation.The key points of operation are the elevated under the orbicularis oculi muscle.The skin orbicularis oculi muscle flaps are formed on both sides of the incision.After the V-Y of the outside myocutaneous flap is advanced and formed at the new medial canthus point,the V-Y of the orbicularis oculi muscle and the skin are sutured in layers.The degree of reduction of the inner canthus width,epicanthal fold shape,incision scarring,and patient satisfaction was followed up.All patients were measured at the preoperative and postoperative review to record data of the intercanthal distance,and used paired t-test for statistical analysis.P<0.05 was statistically significant.Results 83 patients,including 81 female patients and 2 males,with an average age of 28 years(19 to 56 years)were followed up from 3 months to 2 years,with an average of 1 year.The overexposure of the tear caruncle was significantly reduced,the asymmetry of the bilateral inner corners has been improved,the shape of the epicanthal folds reverted to its natural appearance and the old scars became inconspicuous;patient satisfaction evaluation:very satisfied 34.94%(29/83),satisfied 54.22%(45/83),relatively dissatisfied 6.02%(5/83),dissatisfied 4.82%(4/83).Among the 4 cases of dissatisfaction,2 cases were due to insufficient correction and were re-operated to obtain satisfactory result,1 case was improved by reoperating due to excessive correction which led to the reduction of inner canthal distance,1 case regrets surgery the next day after surgery and cannot accept the appearance and strongly requires removal and restoration.The distance between intercanthal distance of the patients was 28.8 mm to 38.0 mm,average(33.58±3.34)mm before the operati

关 键 词：肌皮瓣 内眦赘皮 内眦赘皮矫正术 V-Y成形术 眼畸形 

分 类 号：R779.6[医药卫生—眼科]