Siegel R J
Plast Reconstr Surg. 1987 Jul;80(1):21-8.
Classical techniques, such as wedge resection, are well suited for mild cases of lower lid ectropion, but they often fail to cure severe cases. The reason these techniques often fail is because they address only the laxity and elongation of the ectropic lid, not the root cause. In nearly every case of severe ectropion, the root cause is importance of the pretarsal orbicularis muscle; i.e., there is inadequate muscle support for the pretarsal lower eyelid. A bipedicled musculocutaneous flap, transferred from the upper lid, was used to treat nine cases of severe lower eyelid ectropion. Eight patients had a good/excellent result. Four patients had electromyographic studies in the late postoperative period, without a single instance of even mild denervation. In cases of severe ectropion, this flap is an effective replacement for the missing skin and impotent muscle. It uses the often discarded blepharoplasty tissue, which has a perfect color and texture match. A single anatomic unit is rebuilt, transferring a strong new muscle strap with ideal supporting vectors and leaving scars in natural creases. This "blepharoplasty flap" may prove useful in other types of eyelid reconstruction.
经典技术，如楔形切除术，非常适合轻度下睑外翻病例，但它们往往无法治愈严重病例。这些技术经常失败的原因是它们只解决了外翻眼睑的松弛和伸长问题，而没有解决根本原因。在几乎每一例严重外翻病例中，根本原因是睑前眼轮匝肌的重要性；也就是说，睑前下眼睑缺乏足够的肌肉支撑。从上睑转移的双蒂肌皮瓣用于治疗9例严重下睑外翻。8例患者取得了良好/优异的效果。4例患者在术后晚期进行了肌电图研究，没有一例出现哪怕是轻微的去神经支配情况。在严重外翻病例中，这种皮瓣是缺失皮肤和无力肌肉的有效替代物。它利用了通常被丢弃的睑成形术组织，其颜色和质地完美匹配。重建了一个单一的解剖单元，转移了一条强壮的新肌肉带，具有理想的支撑向量，并在自然皱纹处留下疤痕。这种“睑成形术皮瓣”可能在其他类型的眼睑重建中证明有用。
