Department of Plastic and Reconstructive Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-8509, Japan.
Department of Plastic and Reconstructive Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-8509, Japan.
J Plast Reconstr Aesthet Surg. 2024 Jan;88:266-272. doi: 10.1016/j.bjps.2023.10.133. Epub 2023 Nov 7.
Frontalis suspension surgery is commonly used for the repair of congenital ptosis and involutional blepharoptosis with poor levator function. Grafts for this procedure have been developed using a variety of different materials, each with advantages and disadvantages. The retroauricular fascia graft might be beneficial in this surgery. This article reports the surgical results of blepharoptosis, who were treated with the retroauricular fascia, which is a new autologous graft for the frontalis suspension technique. This case series study targeted patients with ptosis who underwent frontalis suspension surgery with the retroauricular fascia graft at Wakayama Medical University in Japan between May 2016 and May 2023. Patients with insufficient follow-up (<6 months) were excluded from the study. Eligible patients were categorized into one of the following three assessment groups: "good" (improvement of palpebral fissure height without laterality, Margin reflex distance-1 gap between right and left side <0.5 mm), "fair" (improvement of palpebral fissure height with laterality), or "poor" (poor improvement of palpebral fissure height). Thirty-five eyes in 25 patients were treated with the retroauricular fascia graft. The mean postoperative follow-up was 27 months. Eight patients were classified as good (32%), 15 as fair (60%), and two as poor (8%). Two patients (8%) had postoperative lagophthalmos. No patients had eyelash inversion, tarsal deformity, or recurrence of ptosis. Scars along the edge of the hairline were inconspicuous and there were no hypertrophic scars. Functional reconstruction of the eyelids using the retroauricular fascia graft technique is described here for the first time. This grafting technique may be a useful alternative for frontalis suspension surgery because it can be harvested with easy access and without leaving conspicuous scars.
额肌悬吊术常用于修复先天性上睑下垂和提上睑肌功能不良的退行性上睑下垂。该手术的移植物采用了多种不同的材料，每种材料都有其优缺点。耳后筋膜移植物在该手术中可能是有益的。本文报道了采用耳后筋膜行额肌悬吊术治疗上睑下垂的手术结果，耳后筋膜是额肌悬吊术的一种新的自体移植物。本病例系列研究的对象是 2016 年 5 月至 2023 年 5 月在日本和歌山医科大学接受额肌悬吊术联合耳后筋膜移植物治疗的上睑下垂患者。排除随访时间不足 6 个月的患者。符合条件的患者分为以下三组之一：“良好”（眼睑裂高度改善，无偏斜，左右侧 MRD-1 差值<0.5mm）、“一般”（眼睑裂高度改善伴偏斜）或“差”（眼睑裂高度改善差）。25 例患者的 35 只眼接受了耳后筋膜移植物治疗。平均术后随访 27 个月。8 例（32%）患者为良好，15 例（60%）为一般，2 例（8%）为差。2 例（8%）患者术后出现睑闭合不全。无患者出现倒睫、睑板变形或上睑下垂复发。沿着发际线边缘的疤痕不明显，没有增生性疤痕。本文首次描述了使用耳后筋膜移植技术进行眼睑功能重建。这种移植技术可能是额肌悬吊术的一种有用替代方法，因为它可以很容易地获得，且不会留下明显的疤痕。
