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由一位在三级医疗中心拥有15年经验的专科医生实施的眼整形与重建手术的流行病学研究

Epidemiology of Oculoplastic and Reconstructive Surgeries Performed by a Single Specialist With 15 Years' Experience at a Tertiary Center.

作者信息

Lee Joonsik, Lee Hyun Kyu, Lee Hwa, Chang Minwook, Park Minsoo, Baek Sehyun

机构信息

*Korea University College of Medicine, Seoul †Dongguk University, Ilsan Hospital, Goyang ‡Department of Ophthalmology, KEPCO Medical Center, Seoul, Korea.

出版信息

J Craniofac Surg. 2015 Jun;26(4):e308-11. doi: 10.1097/SCS.0000000000001699.

Abstract

PURPOSE

To evaluate the prevalence of oculoplastic surgeries performed in a tertiary hospital in South Korea and to highlight the proper choice of surgery according to disease.

METHOD

Retrospective chart review was conducted over a 12-month period (March 2013 to February 2014) on all of the patients who underwent oculoplastic and reconstructive surgery by a single oculoplastic specialist with 15 years' experience.

RESULTS

A total of 656 patients were enrolled in the current study. Of them, 355 patients (54.1%) had eyelid surgery, 151 patients (23.0%) had orbital surgery, and 150 patients (22.8%) had lacrimal surgery. Orbital surgery was more commonly performed in men (122 male patients versus 29 female patients, P = 0.00 by Pearson chi-squared test) and was also more common in younger patients than in other surgery groups (56.3 years in eyelid surgery versus 39.3 years in orbital surgery versus 46.9 years in lacrimal surgery, P = 0.001 by Pearson chi-squared test). Blepharoplasty was the most common eyelid surgery, contributing 24.2% of total eyelid surgeries, followed by lid mass excision (68 patients, 19.1%), Hotz operation (59 patients, 16.6%), and levator advancement (47 patients, 13.2%). Among orbital surgeries, reconstruction of orbital wall fractures was the most common, and was performed in 89 patients (58.9%) of total orbital surgeries, followed by orbital tumor debulking surgery (25 patients, 16.5%) and orbital decompression for dysthyroid optic neuropathy (19 patients, 12.5%). Endoscopic endonasal dacryocystorhinostomy (DCR) was the most common lacrimal surgery (84 patients), occurring in 56% of total lacrimal surgeries, followed by Monoka tube intubation (16 patients, 10.6%) for congenital nasolacrimal duct obstruction and conjunctivo-DCR using Jones tube (12 patients, 8%).

CONCLUSIONS

Eyelid-related conditions, especially cosmetic blepharoplasty, were among the most commonly encountered surgeries in the Oculoplastics Department of a tertiary care hospital in South Korea. Blowout fracture repair and endoscopic DCR were the most common in orbital and lacrimal surgery. The authors hope that the current survey will contribute to the surgical training of ophthalmology residents and, on a larger scale, health care policies.

摘要

目的

评估韩国一家三级医院进行的眼整形手术的患病率,并强调根据疾病情况正确选择手术方式。

方法

对一位有15年经验的单一眼整形专科医生在12个月期间(2013年3月至2014年2月)进行眼整形和重建手术的所有患者进行回顾性病历审查。

结果

本研究共纳入656例患者。其中,355例患者(54.1%)进行了眼睑手术,151例患者(23.0%)进行了眼眶手术,150例患者(22.8%)进行了泪道手术。眼眶手术在男性中更为常见(122例男性患者对29例女性患者,Pearson卡方检验P = 0.00),并且在年轻患者中也比其他手术组更常见(眼睑手术患者平均年龄56.3岁,眼眶手术患者平均年龄39.3岁,泪道手术患者平均年龄46.9岁,Pearson卡方检验P = 0.001)。睑成形术是最常见的眼睑手术,占眼睑手术总数的24.2%,其次是眼睑肿物切除术(68例患者,19.1%)、霍茨手术(59例患者,16.6%)和提上睑肌前移术(47例患者,13.2%)。在眼眶手术中,眼眶壁骨折修复是最常见的,占眼眶手术总数的89例患者(58.9%),其次是眼眶肿瘤减积手术(25例患者,16.5%)和甲状腺相关眼病性视神经病变的眼眶减压术(19例患者,12.5%)。鼻内镜下泪囊鼻腔造口术(DCR)是最常见的泪道手术(84例患者),占泪道手术总数的56%,其次是先天性鼻泪管阻塞的莫诺卡管插管术(管植入术,16例患者,10.6%)和使用琼斯管的结膜-泪囊鼻腔造口术(12例患者,8%)。

结论

与眼睑相关的疾病,尤其是美容性睑成形术,是韩国一家三级医院眼整形科最常进行的手术之一。眼眶爆裂骨折修复和鼻内镜下泪囊鼻腔造口术分别是眼眶手术和泪道手术中最常见的手术。作者希望当前的调查将有助于眼科住院医师的手术培训,并在更大范围内为卫生保健政策提供参考。

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