Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan, 610041, People's Republic of China.
Aesthetic Plast Surg. 2017 Aug;41(4):863-871. doi: 10.1007/s00266-017-0829-8. Epub 2017 Mar 9.
Epicanthoplasty is a reconstructive procedure that eliminates the deformity of the epicanthal fold and provides a more esthetic inner canthus. The epicanthal tension-releasing incision is a core technique of epicanthoplasty. However, which epicanthal dermatic tension-releasing incision most effectively provides epicanthal tension release remains unclear. We designed a novel dermatic tension-releasing incision based on the skin projection of the inner canthal ligament and compared it with the more conventional incision parallel to the lower inner canthal mucocutaneous junction (white line).
From December 2014 to March 2016, 30 patients were divided into two groups according to the type of dermatic tension-releasing incision. Each group comprised 15 patients and 30 eyes. In Group A, incision line a was performed (tension-releasing incision parallel to the lower inner canthal mucocutaneous junction, 4-5 mm away from the mucocutaneous junction). In Group B, incision line b was performed (tension-releasing incision pointed toward the lacrimal lake, along the skin projection of the inner canthal ligament). The defect angles of the two groups were photographed intraoperatively after tension release and analyzed postoperatively.
The defect angles in Group B were significantly larger than group A (P < 0.0001). All patients obtained an esthetically pleasing inner canthus without hypertrophic scarring or injury to the lacrimal apparatus during the 3- to 24-month follow-up period.
An epicanthal dermatic tension-releasing incision based on the skin projection of the inner canthal ligament is more effective and safer than an incision parallel to the lower inner canthal mucocutaneous junction.
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内眦成形术是一种重建手术，可消除内眦赘皮的畸形，并提供更美观的内眦。内眦张力释放切口是内眦成形术的核心技术。然而，哪种内眦皮肤张力释放切口最有效地提供内眦张力释放仍不清楚。我们根据内眦韧带的皮肤投影设计了一种新的皮肤张力释放切口，并将其与更传统的平行于下内眦黏膜皮肤交界处（白线）的切口进行了比较。
2014 年 12 月至 2016 年 3 月，根据皮肤张力释放切口的类型将 30 例患者分为两组。每组 15 例患者，共 30 只眼。在 A 组中，行切口线 a（平行于下内眦黏膜皮肤交界处的张力释放切口，距黏膜皮肤交界处 4-5mm）。在 B 组中，行切口线 b（指向泪湖的张力释放切口，沿内眦韧带的皮肤投影）。在释放张力后，术中拍摄两组的缺损角度，并在术后进行分析。
B 组的缺损角度明显大于 A 组（P<0.0001）。所有患者在 3 至 24 个月的随访期间均获得了美观的内眦，无肥厚性瘢痕或泪器损伤。
基于内眦韧带皮肤投影的内眦皮肤张力释放切口比平行于下内眦黏膜皮肤交界处的切口更有效、更安全。
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