经鼻肌腱悬吊术治疗麻痹性下睑下垂
Transnasal tendon suspension for the paralyzed lower eyelid.
作者信息
Yoo John, Matic Damir
机构信息
Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Center, Victoria Hospital, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Department of Surgery, Division of Plastic and Reconstructive Surgery, London Health Sciences Center, Victoria Hospital, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
出版信息
J Plast Reconstr Aesthet Surg. 2015 Aug;68(8):1072-8. doi: 10.1016/j.bjps.2015.04.008. Epub 2015 Apr 20.
BACKGROUND
Paralytic ectropion is a significantly functional and esthetic problem leading to problems with lacrimation, corneal exposure, and poor palpebral closure. Limitations with traditional corrective procedures include poor apposition of the lid to the globe, suboptimal medial canthal position, and high recurrence rates.
OBJECTIVE
The objective of this study was to develop a technique of lower-lid suspension using transnasal wiring for the long-term maintenance of lid position.
METHODS
Twenty-three consecutive patients with complete unilateral facial nerve paralysis underwent the procedure, and they were followed up for a median of 27 months (1-73 months).
RESULTS
Fifteen of 18 patients maintained their intraoperative lower-lid position beyond the 12-month follow-up. Three patients had a minimal scleral show at 3 months. One of these patients also developed lid laxity seen on the snap test. No perioperative complications were experienced.
CONCLUSIONS
Transnasal wiring of the lower-lid tendon suspension provides consistent results that are maintained over time.
背景
麻痹性睑外翻是一个严重的功能和美观问题，会导致流泪、角膜暴露及睑裂闭合不良等问题。传统矫正手术存在局限性，包括眼睑与眼球贴合不佳、内眦位置不理想以及复发率高。
目的
本研究的目的是开发一种经鼻布线的下睑悬吊技术，用于长期维持眼睑位置。
方法
连续23例单侧完全性面神经麻痹患者接受了该手术，并进行了中位27个月（1 - 73个月）的随访。
结果
18例患者中有15例在12个月的随访期后仍保持术中的下睑位置。3例患者在3个月时出现轻微巩膜暴露。其中1例患者在瞬目试验中也出现了眼睑松弛。未发生围手术期并发症。
结论
下睑肌腱悬吊经鼻布线可提供持续稳定的效果，并能长期维持。
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