Aesthet Surg J. 2024 May 15;44(6):580-587. doi: 10.1093/asj/sjae004.
The epicanthal fold (EF) is a semilunar skin fold located in the medial canthus in most Asians. The medial canthus fibrous band (MCFB) reportedly plays a critical role in EF formation. Variations in MCFB shape and size affect the severity and type of EF.
We aimed to analyze MCFB variations in different types and severities of EF and explore the effect of the MCFB resection epicanthoplasty technique (MCFB epicanthoplasty).
Surgical videos of 40 patients undergoing MCFB epicanthoplasty in our department were reviewed. The MCFB (area), transverse dimension, vertical dimension, upper eyelid direction length (UEDL), and lower eyelid direction length (LEDL) were measured. For aesthetic assessment, 37 patients were followed up for 6 months; intercanthal distance (ICD) and horizontal lid fissure length (HLFL) were measured. Preoperative and postoperative ICD/HLFL ratios were compared. Postoperative scar recovery was evaluated with the Patient and Observer Scar Assessment Scale. Statistical significance was set at P < .05.
The MCFB diameter and area were larger for severe EF than for moderate EF (P < .01). Patients with severe EF had larger LEDL than UEDL (P < .01). The tarsalis type had a larger LEDL than the palpebralis type with the same severity (P < .01). MCFB epicanthoplasty yielded favorable postoperative cosmetic effects and scar recovery. Postoperative ICD decreased, while HLFL increased compared to preoperative values (P < .001). The ICD/HLFL ratio was significantly lower postoperatively than preoperatively (P < .001). Postoperative ICD/HLFL ratio was 1.2:1.
The MCFB affects the severity and type of EF. MCFB epicanthoplasty effectively corrected moderate to severe EF.
内眦赘皮是一种半月形的皮肤褶皱，位于大多数亚洲人的内眦。据报道，内眦纤维带（MCFB）在形成内眦赘皮中起着关键作用。MCFB 形状和大小的变化会影响内眦赘皮的严重程度和类型。
我们旨在分析不同类型和严重程度的内眦赘皮中 MCFB 的变化，并探讨 MCFB 切除术内眦成形术（MCFB 内眦成形术）的效果。
回顾了我科 40 例行 MCFB 内眦成形术患者的手术视频。测量 MCFB（面积）、横径、竖径、上睑方向长度（UEDL）和下睑方向长度（LEDL）。为了美学评估，对 37 例患者进行了 6 个月的随访；测量内眦间距（ICD）和水平睑裂长度（HLFL）。比较了术前和术后 ICD/HLFL 比值。采用患者和观察者瘢痕评估量表评估术后瘢痕恢复情况。P<.05 为差异有统计学意义。
重度内眦赘皮的 MCFB 直径和面积均大于中度内眦赘皮（P<.01）。重度内眦赘皮患者的 LEDL 大于 UEDL（P<.01）。与同一严重程度的睑型相比，腱膜型的 LEDL 更大（P<.01）。MCFB 内眦成形术术后美容效果和瘢痕恢复良好。与术前相比，术后 ICD 减小，HLFL 增加（P<.001）。术后 ICD/HLFL 比值明显低于术前（P<.001）。术后 ICD/HLFL 比值为 1.2:1。
MCFB 影响内眦赘皮的严重程度和类型。MCFB 内眦成形术可有效矫正中重度内眦赘皮。
