中国修复重建外科杂志

中国修复重建外科杂志

改良横切纵缝法内眦赘皮矫正术的临床疗效分析

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目的介绍一种改良横切纵缝法内眦赘皮矫正术并总结其临床疗效。方法回顾分析 2014 年 2 月—2016 年 12 月采用改良横切纵缝法内眦赘皮矫正术治疗且随访时间达 6 个月以上的 119 例患者临床资料。其中男 8 例,女 111 例;年龄 18~38 岁,平均 22.7 岁。内眦赘皮呈眉型 12 例,睑型 57 例,睑板型 39 例,倒向型 11 例。其中轻度(覆盖泪阜<1 3="" 42="" 1="" 3="" 2="" 3="" 58="">2/3)19 例。内眦赘皮行单纯矫正术 6 例,同期行重睑术 113 例。依据内眦生理美学进行新内眦点定位,通过短横切口对内眦韧带浅面错构的眼轮匝肌及内眦韧带至皮肤的纤维连接进行分离、重置,将内眦韧带进行精确缩短折叠后,对术区顺应眼周郎格线进行无张力对位缝合。结果患者术后切口均Ⅰ期愈合。119 例均获随访,随访时间 6 个月~2 年,平均 8.6 个月。3 例患者术后 3~6 个月出现内眦术区瘢痕增生明显,局部使用得宝松注射联合硅凝胶及 CO2 激光治疗后 10 个月瘢痕萎缩变平。其余患者内眦赘皮术后均改善良好,内眦间距明显缩窄,双侧睑裂长度增加,泪阜充分显露,内眦角形态自然,术区未见明显瘢痕,效果满意。结论改良横切纵缝法内眦赘皮矫正术具有手术设计及操作简便,创伤小,术后效果明显、稳定、持久,瘢痕不明显等优点。

ObjectiveTo introduce a modified transsection and longitudinal suture in epicanthoplasty and summarize its effectiveness.MethodsThe clinical data of 119 patients underwent epicanthoplasty with modified transsection and longitudinal suture and with a follow-up time over 6 months between February 2014 and December 2016 were retrospectively analyzed. There were 8 males and 111 females with an average age of 22.7 years (range, 18-38 years). The epicanthus was as eyebrow type in 12 cases, as eyelid type in 57 cases, as tarsalis type in 39 cases, and as backward type in 11 cases. The narrow degree of epicanthus included mild (the lacrimal caruncle covered size was less than 1/3) in 42 cases, moderate (the lacrimal caruncle covered size was between 1/3 and 2/3) in 58 cases, and severe (the lacrimal caruncle covered size was over 2/3) in 19 cases. One hundred and thirteen patients were treated by blepharoplasty at the same time. The new canthus was located on the basis of the inner canthus physiological aesthetics. Through a short transverse incision, dislocated orbicularis oculi muscle near medial canthal ligament and the fiber between the medial canthal ligament and skin were completely released; then the medial canthal ligament was shortened precisely and the incision was tension-free sutured followed the Langer’s line near eyes.ResultsAll the incisions healed by first intention. All patients were followed up 6 months to 2 years (mean, 8.6 months). The bilateral hypertrophic scar on both bilateral medial canthal incisions happened in 3 patients at 3-6 months after operation; and the scarring gradually subsided at 10 months after the diprospan injections and the siliconegel and carbon dioxide laser treatment. Good effectiveness were obtained in the other patients, whose inner intercanthal distance significantly narrowed, both of the horizontal lid fissure length increased, the lacrimal caruncle fully exposed, and no obvious scar could be seen.ConclusionThe modified transsection and longitudinal suture in epicanthoplasty has the advantages of simple design, easy operation, minimally invasive, inconspicuous scar, and obvious, stable, and lasting postoperative effectiveness.

关键词: 内眦赘皮矫正术; 横切纵缝法; 改良

Key words: Epicanthoplasty; transsection and longitudinal suture; modify

引用本文: 万珺, 文辉才. 改良横切纵缝法内眦赘皮矫正术的临床疗效分析. 中国修复重建外科杂志, 2018, 32(3): 354-357. doi: 10.7507/1002-1892.201710016 复制

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