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经睑成形术切口行上睑旋转皮瓣矫正轻至中度内眦赘皮的疗效

[Effectiveness of upper eyelid rotation flap via blepharoplasty incision for correction of mild to moderate epicanthus].

作者信息

Guo Fangfang, Ning Guansen

机构信息

Department of Plastic and Reconstruction Surgery, Zhongda Hospital, Southeast University, Nanjing Jiangsu, 210009, P.R.China.

Department of Plastic and Reconstruction Surgery, Zhongda Hospital, Southeast University, Nanjing Jiangsu, 210009,

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 Feb 15;33(2):203-206. doi: 10.7507/1002-1892.201805097.

Abstract

OBJECTIVE

To evaluate an modified epicanthoplasty which can reduce epicanthic scar in blepharoplasty with mild to moderate epicanthus, by using upper eyelid rotation flap via blepharoplasty incision.

METHODS

A clinical data of 34 patients with mild and moderate epicanthus (trial group), who were treated with blepharoplasty and epicanthoplasty by using upper eyelid rotation flap, between July 2016 and October 2017, was retrospectively analyzed. And 38 patients who were treated with blepharoplasty and epicanthoplasty by using traditional "Z" plastic method were recruited as control group. There was no significant difference in age and degree of epicanthus between 2 groups ( >0.05). The lengths of palpebral fissure were measured at preoperation and at 6 days and 6 months after operation, and the length difference between pre- and post-operation was calculated to evaluate the improvement degree. The effectiveness was evaluated with reference to the scale of epicanthus orthopedics.

RESULTS

All incisions of 2 groups healed by first intention, and all patients were followed up 6 months. The epicanthi of 2 groups were significantly corrected. The inner canthus of trial group had no incision; and there were scars at inner canthus of control group, with obvious hyperplasia in 6 cases. The improvement degree of the length of palpebral fissure in trial group and control group were 3.63%±0.07%, 3.70%±0.05% and 4.64%±0.09%, 4.46%±0.10% at 6 days and 6 months after operation, respectively. There was no significant difference between 2 groups ( =0.005, =0.996; =0.287, =0.871). The effectiveness was excellent in 20 cases, good in 12 cases, and poor in 2 cases in trial group, with an excellent and good rate of 94.12%; meanwhile, the effectiveness was excellent in 16 cases, good in 16 cases, and poor in 6 cases in control group, with an excellent and good rate of 84.21%. There was no significant difference between 2 groups ( =0.796, =0.372).

CONCLUSION

The modified epicanthoplasty by using upper eyelid rotation flap via blepharoplasty incision can significantly reduce epicanthic scar with simple operation and satisfactory effectiveness.

摘要

目的

通过睑成形术切口采用上睑旋转皮瓣,评估一种改良的内眦赘皮矫正术,该术式可减少轻至中度内眦赘皮患者睑成形术中的内眦瘢痕。

方法

回顾性分析2016年7月至2017年10月采用上睑旋转皮瓣行睑成形术及内眦赘皮矫正术的34例轻、中度内眦赘皮患者(试验组)的临床资料。选取38例采用传统“Z”成形法行睑成形术及内眦赘皮矫正术的患者作为对照组。两组患者年龄及内眦赘皮程度差异无统计学意义(P>0.05)。分别于术前、术后6天及6个月测量睑裂长度,并计算手术前后的长度差值以评估改善程度。参照内眦赘皮整形评分标准评估疗效。

结果

两组患者切口均一期愈合,所有患者均随访6个月。两组内眦赘皮均得到明显矫正。试验组内眦部无切口;对照组内眦部有瘢痕,其中6例瘢痕增生明显。试验组和对照组术后6天及6个月睑裂长度改善程度分别为3.63%±0.07%、3.70%±0.05%和4.64%±0.09%、4.46%±0.10%,两组比较差异无统计学意义(P=0.005,P=0.996;P=0.287,P=0.871)。试验组优20例,良12例,差2例,优良率为94.12%;对照组优16例,良16例,差6例,优良率为84.21%,两组比较差异无统计学意义(P=0.796,P=0.372)。

结论

通过睑成形术切口采用上睑旋转皮瓣的改良内眦赘皮矫正术,手术操作简单,能显著减少内眦瘢痕,疗效满意。

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本文引用的文献

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Relationship between lower eyelid epiblepharon and epicanthus in Korean children.韩国儿童下睑赘皮与内眦赘皮的关系。
PLoS One. 2017 Nov 21;12(11):e0187690. doi: 10.1371/journal.pone.0187690. eCollection 2017.
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[Surgical Treatment of Medial Epicanthus by Skin Replacement].[皮肤置换术治疗内眦赘皮]
Klin Monbl Augenheilkd. 2016 Jan;233(1):50-3. doi: 10.1055/s-0041-109404. Epub 2016 Jan 21.

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