de la Torre Jorge I, Paulsen Stephen M, Decordier Benoit, Al-Hakeem Mazin S, Vasconez Luis O
University of Alabama at Birmingham, Division of Plastic Surgery, and Center for Advanced Surgical Aesthetics, Birmingham, AL 35294-3411, USA.
Ann Plast Surg. 2005 Mar;54(3):251-5.
The development of endoscopic surgical techniques has allowed an evolution from the standard coronal forehead lift to a minimally invasive one. Endoscopy avoids many of the undesirable results of the coronal approach while it remains very efficacious. The purpose of this study is to evaluate the effectiveness and safety of endoscopic forehead lift in patients who have previously undergone coronal brow lift.
A retrospective review was performed on the medical records of 726 consecutive patients who had undergone endoscopic forehead lift between 1994 and 2004. Sixty-three patients were identified who had undergone prior coronal incision brow lift and then required subsequent elevation of the forehead using endoscopy. Those who had persistent low eyebrows and forehead wrinkles underwent the standard minimal incision endoscopic approach. Patients with severe brow ptosis and excessive height of the forehead underwent a biplanar endoscopic forehead lift.
Of the 63 endoscopic forehead lifts performed, 49 used the minimal access technique, while 14 employed the biplanar approach. The subject population consisted of 58 female and 5 male patients whose average age was 57 years (range of 42 to 80 years). Eighty-seven percent of these brow lifts also had concomitant rhytidectomy, and 4% had blepharoplasty. Average follow-up was 21 months (range 1 to 7 years). Following the endoscopic procedure, none of the patients had frontal nerve injury, alopecia, or persistent glabellar wrinkle lines. Complications included 1 forehead dysesthesia, 1 forehead irregularity, 1 eyebrow malposition, 1 persistent horizontal forehead wrinkling, and 2 hematomas. Operative management was not required for any of these complications.
The secondary endoscopic forehead lift is effective in rejuvenating the upper face in the patient who has had a previous coronal forehead lift. It elevates the eyebrows and reduces both transverse and vertical wrinkles while avoiding further displacement of the hairline. The low rate of complications is comparable to that of primary endoscopic forehead lifts. Finally, serial follow-up indicates that the results are effective at correcting brow ptosis and are long lasting.
内镜手术技术的发展使得从标准冠状前额提升术演变为微创前额提升术成为可能。内镜手术避免了冠状入路的许多不良后果，同时仍然非常有效。本研究的目的是评估内镜前额提升术对先前接受过冠状眉提升术患者的有效性和安全性。
对1994年至2004年间连续接受内镜前额提升术的726例患者的病历进行回顾性研究。确定了63例先前接受过冠状切口眉提升术，随后需要通过内镜进行前额提升的患者。那些眉毛持续低垂和前额有皱纹的患者采用标准的小切口内镜入路。严重眉下垂和前额过高的患者接受双平面内镜前额提升术。
在进行的63例内镜前额提升术中，49例采用了微创技术，14例采用了双平面入路。研究对象包括58名女性和5名男性患者，平均年龄为57岁（范围为42至80岁）。这些眉提升术中87%同时进行了除皱术，4%进行了眼睑成形术。平均随访时间为21个月（范围为1至7年）。内镜手术后，没有患者出现额神经损伤、脱发或持续的眉间皱纹。并发症包括1例前额感觉异常、1例前额不平整、1例眉位置异常、1例前额水平皱纹持续存在和2例血肿。这些并发症均无需手术处理。
二次内镜前额提升术对于先前接受过冠状前额提升术的患者面部上半部分的年轻化是有效的。它可以提升眉毛，减少横向和纵向皱纹，同时避免发际线进一步移位。并发症发生率低，与初次内镜前额提升术相当。最后，系列随访表明，该结果在矫正眉下垂方面有效且持久。
