Stanford University Division of Plastic and Reconstructive Surgery, Stanford, CA, USA.
J Plast Reconstr Aesthet Surg. 2012 Feb;65(2):249-51. doi: 10.1016/j.bjps.2011.06.035. Epub 2011 Jul 20.
Ectropion is frequently encountered in plastic surgery. A variety of etiologies exist, but tarsal ectropion, defined as complete eversion of the tarsal plate and its overlying conjunctiva, is rarely considered. First described in 1960 by Fox, this variant was initially attributed to pre-septal orbicularis oculi spasm or tarsoligamentous relaxation. However, subsequent investigators determined that the true etiology involved lower lid retractor disinsertion on the tarsal plate. We present a case of chronic right lower lid ectropion in a 66-year-old male. Through understanding of eyelid anatomy, especially that of the lower eyelid retractors, tarsal ectropion was correctly identified in our patient preoperatively. A repair including correction of retractor disinsertion on the tarsus was planned, and given our patient's degree of lower lid delamination and mobilization, we also proceeded with bilateral lower lid blepharoplasty with canthal and lower lid soft tissue support. Ultimately, we were able to achieve an improved aesthetic appearance for our patient, along with resolution of his symptoms.
下睑外翻在整形外科学中较为常见。其病因多样，但以睑板及其表面结膜完全外翻为特征的 睑 外翻较为罕见。这种类型最初由 Fox 于 1960 年描述，起初被认为与眼轮匝肌预部痉挛或睑板腱膜松弛有关。然而，后续研究表明真正的病因涉及下睑缩肌在睑板上的撕脱。我们报告了 1 例 66 岁男性的慢性右侧下睑外翻。通过对眼睑解剖结构的理解，特别是对下眼睑缩肌的理解，我们在术前正确识别了我们患者的睑 外翻。计划进行包括纠正睑板撕脱的修复手术，鉴于我们患者的下睑分层和活动度，我们还对双侧下睑进行了眼睑成形术，并进行了内眦和下睑软组织支撑。最终，我们成功地改善了患者的美观外观，并解决了他的症状。
