有无外侧角切口的上睑提肌腱膜前移手术外侧角切口对严重内陷性睑外翻的影响

IF 3.2 2区 医学 Q1 SURGERY
Plastic and reconstructive surgery Pub Date : 2025-06-01 Epub Date: 2024-10-18 DOI:10.1097/PRS.0000000000011833
Hirotaka Suga, Asako Fukuju, Risa Murakami
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引用次数: 0

摘要

背景:上睑提肌腱膜的外侧部分转化为纤维组织,称为外侧角。治疗内陷性睑外翻的传统上睑下垂矫正术保留了外侧角的完整性。切开外侧角的影响尚未得到深入研究:研究对象包括在 2020 年至 2023 年间接受过上睑提肌前移手术治疗内陷性睑外翻的 69 例患者。在手术中,如果提上睑肌腱膜不能很好地前移,我们会切开外侧角以增加前移量。然后,我们回顾性地查看了有无切口的病例。我们还在术中使用带有刻度网格的纸张测量了切口的效果:结果:在 69 例病例中,有 32 例进行了侧角切口。必须进行切口的病例术前睑外翻程度明显更严重(边缘反射距离1;0.5 vs 1.0 mm,P <0.05)。接受切开术的患者年龄明显大于未接受切开术的患者(73.4 岁 vs 61.7 岁,P < 0.05)。两组患者的术后边缘反射距离 1(2.8 mm vs 3.0 mm,P = 0.20)无明显差异。术中测量显示,侧角切口使提上睑肌腱膜向尾部推进了4.3毫米,向内侧推进了3.1毫米:结论:外侧角切口在重度内翻性睑外翻的上睑提肌腱膜前移手术中非常有效。该技术有助于防止睑裂矫正不足,尤其是在内侧区域。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Levator Advancement Surgery with or without Lateral Horn Incision: Effect of Lateral Horn Incision for Severe Involutional Blepharoptosis.

Background: The lateral portion of the levator aponeurosis transforms into fibrous tissue called the lateral horn. Conventional levator advancement surgery for involutional blepharoptosis preserves the integrity of the lateral horn. The impact of incising the lateral horn has not been thoroughly studied.

Methods: Sixty-nine patients who had undergone levator advancement surgery for involutional blepharoptosis between 2020 and 2023 were included in the study. In cases where the levator aponeurosis could not be well advanced during surgery, the authors incised the lateral horn to increase the advancement. The authors then retrospectively reviewed cases with or without the incision. The authors also measured the effect of the incision intraoperatively using a sheet with a scale grid.

Results: Lateral horn incisions were performed in 32 of the 69 cases. The preoperative degree of blepharoptosis was significantly more severe in cases that necessitated the incision (margin reflex distance 1, 0.5 mm versus 1.0 mm; P < 0.05). Patients receiving the incision were significantly older than those without (73.4 years versus 61.7 years; P < 0.05). There were no significant differences between the 2 groups in postoperative margin reflex distance 1 (2.8 mm versus 3.0 mm; P = 0.20). Intraoperative measurements revealed that the levator aponeurosis was advanced 4.3 mm more caudally and 3.1 mm more medially as a result of the lateral horn incision.

Conclusions: Lateral horn incision is effective in levator advancement surgery for severe involutional blepharoptosis. This technique aids in preventing undercorrection of palpebral fissures, especially in the medial region.

Clinical question/level of evidence: Therapeutic, IV.

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来源期刊
CiteScore
5.00
自引率
13.90%
发文量
1436
审稿时长
1.5 months
期刊介绍: For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis. Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.
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