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1例提上睑肌腱膜退变所致上睑下垂患者。

One Patient of Blepharoptosis Caused by Levator Palpebrae Superioris Aponeurosis Degeneration.

作者信息

Tang Shoukai, Hu Yanuan, Wang Yuanbo, Lu Junxu, Yang Biaobing

机构信息

Weifang Medical University, Weifang, China.

出版信息

J Craniofac Surg. 2022;33(8):e866-e869. doi: 10.1097/SCS.0000000000008799. Epub 2022 Jul 22.

Abstract

Ptosis is one of the common diseases of plastic surgery, which is caused by various causes of levator palpebrae superioris dysfunction or Müller muscle insufficiency, which is manifested by the upper eyelid margin being lower than normal when level viewed. Ptosis can be divided into congenital and acquired, and the main cause of congenital ptosis is due to congenital levator palpebrae superioris dysplasia or the motor nerve innervation that innervates it is caused by abnormal oculomotor neurodevelopment and dysfunction. Acquired ptosis can be divided into traumatic, neurogenic, myogenic, senile, mechanical, and false ptosis. At present, there are few reports of ptosis due to the degeneration of the aponeurosis of the upper eyelid muscle. We received a case of ptosis caused by degeneration of the levator palpebrae superioris aponeurotic membrane, we use the method of the levator palpebrae superioris high advancement. The levator palpebrae superioris-Miller muscle was folded to form a stable composite structure by the levator palpebrae superioris high advancement. During the operation, the levator palpebrae superioris was separated along the gap, and the surrounding tissues were less damaged. Therefore, postoperative adhesion was less, and the main complications of severe blepharoptosis after the operation, such as upper eyelid hysteresis and incomplete closure, almost did not occur, and after surgery, the results were good.

摘要

上睑下垂是整形外科的常见疾病之一,它由多种原因导致提上睑肌功能障碍或 Müller 肌功能不全引起,平视时表现为上睑缘低于正常。上睑下垂可分为先天性和后天性,先天性上睑下垂的主要原因是先天性提上睑肌发育不良或支配它的运动神经因动眼神经发育异常和功能障碍所致。后天性上睑下垂可分为外伤性、神经源性、肌源性、老年性、机械性和假性上睑下垂。目前,因上睑肌腱膜退变导致上睑下垂的报道较少。我们收治了 1 例因提上睑肌腱膜退变导致的上睑下垂患者,采用提上睑肌高位上徙术。通过提上睑肌高位上徙,将提上睑肌 - Müller 肌折叠形成稳定的复合结构。手术过程中,沿间隙分离提上睑肌,对周围组织损伤较小。因此,术后粘连较少,术后重度上睑下垂的主要并发症如睑迟滞和闭合不全几乎未发生,术后效果良好。

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