Balaji S M
Director and Consultant, Oral and Maxillofacial Surgeon, Balaji Dental and Craniofacial Hospital, Chennai, Tamil Nadu, India.
Indian J Dent Res. 2018 Mar-Apr;29(2):166-170. doi: 10.4103/ijdr.IJDR_147_18.
The purpose of this study is to assess the outcomes of frontalis sling using fascia lata and silicone aurosling for congenital unilateral ptosis patients with poor levator function.
Retrospective study of archival cases from 22 patients from author's center. All the patients with unilateral ptosis with poor levator function were included excluding those having poor Bell's phenomenon and associated pathology like jaw winking, 3 nerve misdirection, squint, impaired corneal sensitivity, and neoplastic lesions. Patients were diagnosed based on the history and clinical examination including measurements. Corrections were performed by single surgeon. Marginal reflex distance-1 (MRD1) values observed preoperatively, immediate postoperatively, and late postoperatively in both groups.
: Of the 22 cases, 12 were treated with fascia while the remaining 10 were treated with silicone aurosling material. The mean age of the fascia group was 11.42 ± 3.55 years while it was 14 ± 4.2 years for the silicone group. There were 10 males and 12 females in the study group. The mean follow-up in the study group was 20.14 ± 2.05 months, and the difference between the groups was not statistically significant. The difference between the two groups at the preoperative and immediate postoperative did not vary with statistical significance (P = 0.926 and P = 0.242, respectively). The late postoperative MRD1 did vary significantly between the two groups. The mean late postoperative MRD1 for fascia group was 3.67 ± 0.32 with a range of 3.1-4.15 while for the silicone group was 3.2 ± 0.46 with a range of 2.5-4. The difference was statistically significant (P = 0.023).
The stability of the change in silicone aurosling group was relatively less as compared to the fascia lata. The recent material aspect study of such silicone aurosling material indicates that they are susceptible to damage and that cause the loss of stability. More studies with larger sample size and longer follow-up are needed.
本研究旨在评估使用阔筋膜和硅胶金吊带治疗提上睑肌功能不良的先天性单侧上睑下垂患者的疗效。
对作者所在中心22例存档病例进行回顾性研究。纳入所有单侧上睑下垂且提上睑肌功能不良的患者,排除贝尔现象不良以及伴有颌动瞬目、三叉神经错向、斜视、角膜感觉减退和肿瘤性病变等相关病理情况的患者。根据病史和包括测量在内的临床检查对患者进行诊断。所有矫正手术均由同一位外科医生完成。观察两组患者术前、术后即刻和术后晚期的边缘反射距离-1(MRD1)值。
22例患者中,12例采用阔筋膜治疗,其余10例采用硅胶金吊带材料治疗。阔筋膜组的平均年龄为11.42±3.55岁,硅胶组为14±4.2岁。研究组中有10名男性和12名女性。研究组的平均随访时间为20.14±2.05个月,两组之间的差异无统计学意义。两组术前和术后即刻的差异无统计学意义(分别为P = 0.926和P = 0.242)。两组术后晚期的MRD1差异有统计学意义。阔筋膜组术后晚期MRD1的平均值为3.67±0.32,范围为3.1 - 4.15,而硅胶组为3.2±0.46,范围为2.5 - 4。差异有统计学意义(P = 0.023)。
与阔筋膜相比,硅胶金吊带组变化的稳定性相对较差。近期对这种硅胶金吊带材料的材料学方面研究表明,它们易受损伤,从而导致稳定性丧失。需要进行更多样本量更大、随访时间更长的研究。