Park Hojin, Moon Yijun, Kim Da Som, Park Seung Ha
Department of Plastic Surgery, Korea University, College of Medicine, Korea University Anam Hospital, Seoul, Korea.
J Craniofac Surg. 2024 Feb 27. doi: 10.1097/SCS.0000000000010058.
Many surgical techniques for managing epicanthal folds have been reported, but their main drawbacks include a noticeable scar in Asians, acute medial canthal angle, and applicability only in mild or moderate epicanthal folds. This study described a novel surgical technique, Y-W epicanthoplasty, and assessed the medial canthal shape and scarring in patients who underwent Y-W epicanthoplasty. Patients with moderate or severe epicanthal folds between January 2004 and February 2017 were included in this study. Pre- and postoperative intercanthal distance (ICD), inner canthal angle (ICA), and interpupillary distance (IPD) were measured. The ICD ratios (ICD/IPD) and extent of postoperative scarring were evaluated. A Y-W epicanthoplasty was performed on 18 patients. The ICD ratio of the total study cohort showed a significant reduction following surgery (preoperative ICD ratio=0.62±0.04, postoperative ICD ratio=0.58±0.03, P<0.001). The ICA was 51.8±7.7° and 49.8±5.6° in the pre- and postoperative periods, respectively (P=0.086) Eleven patients showed no apparent scar, and 6 patients were found to have minimal scarring that was visible only under close inspection. One patient had a hypertrophic scar that was successfully managed with triamcinolone acetonide injections. Y-W epicanthoplasty can provide good aesthetic results without a visible scar in patients with moderate-to-severe epicanthal folds. The Y-W epicanthoplasty avoids a medially extended skin incision and excessive tension on the skin flaps. Moreover, an acutely shaped or webbed medial canthus after epicanthoplasty can be prevented by adding a small triangular flap. The Y-W epicanthoplasty procedure is simple and straightforward, and it is appropriate for moderate-to-severe epicanthal fold correction.
已有许多用于处理内眦赘皮的手术技术被报道，但它们的主要缺点包括在亚洲人身上会留下明显疤痕、内眦角尖锐以及仅适用于轻度或中度内眦赘皮。本研究描述了一种新型手术技术——Y-W内眦成形术，并评估了接受Y-W内眦成形术患者的内眦形态和瘢痕情况。本研究纳入了2004年1月至2017年2月间患有中度或重度内眦赘皮的患者。测量术前和术后的内眦间距（ICD）、内眦角（ICA）和瞳孔间距（IPD）。评估ICD比率（ICD/IPD）和术后瘢痕程度。对18例患者实施了Y-W内眦成形术。整个研究队列的ICD比率在术后显著降低（术前ICD比率=0.62±0.04，术后ICD比率=0.58±0.03，P<0.001）。术前和术后的ICA分别为51.8±7.7°和49.8±5.6°（P=0.086）。11例患者无明显瘢痕，6例患者有轻微瘢痕，仅在仔细检查时可见。1例患者有增生性瘢痕，通过曲安奈德注射成功处理。Y-W内眦成形术可为中度至重度内眦赘皮患者提供良好的美学效果且无明显瘢痕。Y-W内眦成形术避免了在内侧延长皮肤切口以及皮瓣上的过度张力。此外，通过添加一个小三角形皮瓣可防止内眦成形术后内眦角呈锐角形或蹼状。Y-W内眦成形术操作简单直接，适用于中度至重度内眦赘皮的矫正。
