Jin Yunbo, Lyu Dongze, Chen Hui, Ma Gang, Qiu Yajing, Zou Yun, Tremp Mathias, Lin Xiaoxi
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, China.
Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University, School of Medicine, China; Department of Plastic Surgery, The Second Affiliated Hospital of Nanjing Medical University, China.
J Plast Reconstr Aesthet Surg. 2017 Jul;70(7):952-958. doi: 10.1016/j.bjps.2017.01.014. Epub 2017 Feb 16.
Presently, many techniques have been described to make the epicanthal fold less prominent. However, visible scarring remains a major concern in most techniques. The aim of this study was to develop a novel design using concealed incisions with minimal tension.
Between December 2010 and May 2015, charts were reviewed from patients who underwent a concealed incision and tension-free technique to correct the epicanthal fold. The intercanthal distance (ICD), interpupillary distance (IPD), scar visibility, and cosmetic results were evaluated preoperatively and 1 year after the surgery. The ratio of the ICD to IPD (ICD ratio) was calculated, and the visibility of the scar was assessed.
In total, 136 patients (mean age 25.2 ± 2.7 years, range 20-32 years) were included. The preoperative median ICD ratio was 0.60 (range, 0.54-0.68) and decreased to 0.54 (range, 0.48-0.62) postoperatively. The median ICD ratio reduction was 9.1% (range, 3.6%-22.0%; P < 0.001, Wilcoxon signed-rank test). One hundred and thirty-four patients (98.5%) had no visible scarring or minimal scarring visible only under close inspection. Two patients (1.5%) experienced a more prominent scar, but none of them developed a severe scar requiring revision. The aesthetic outcome judged by the patient and surgeon was excellent or good in all cases.
From our experience, the scar after medial epicanthoplasty can be minimized by using a concealed incision and tension-free technique. Our technique is an effective and individualized method, leading to a high satisfaction rates.
目前，已有多种技术可使内眦赘皮不那么明显。然而，在大多数技术中，明显的瘢痕仍是一个主要问题。本研究的目的是开发一种采用隐蔽切口且张力最小的新设计。
回顾2010年12月至2015年5月期间接受隐蔽切口无张力技术矫正内眦赘皮患者的病历。术前及术后1年评估内眦间距（ICD）、瞳孔间距（IPD）、瘢痕可见度及美容效果。计算ICD与IPD的比值（ICD比值），并评估瘢痕的可见度。
共纳入136例患者（平均年龄25.2±2.7岁，范围20 - 32岁）。术前ICD比值中位数为0.60（范围0.54 - 0.68），术后降至0.54（范围0.48 - 0.62）。ICD比值中位数降低了9.1%（范围3.6% - 22.0%；P < 0.001，Wilcoxon符号秩检验）。134例患者（98.5%）无可见瘢痕或仅在仔细检查下可见轻微瘢痕。2例患者（1.5%）瘢痕较明显，但均未出现需要修复的严重瘢痕。患者和外科医生判断的美学效果在所有病例中均为优秀或良好。
根据我们的经验，采用隐蔽切口无张力技术可使内眦成形术后的瘢痕最小化。我们的技术是一种有效且个体化的方法，满意度高。
