Roggenkämper P, Nüssgens Z
Universitäts-Augenklinik der Rheinischen Friedrich-Wilhelms-Universität, Bonn, Germany.
Graefes Arch Clin Exp Ophthalmol. 1997 Aug;235(8):486-9. doi: 10.1007/BF00947004.
Thirty-one patients with essential blepharospasm or lid opening disorder of the levator-inhibiting type, unresponsive to treatment with botulinum toxin, underwent frontalis suspension. Twenty-eight patients received bilateral surgery (three patients with bilateral complaints of different severity were operated on the more affected side; these patients were not included in the statistical analysis). The mean age was 62.4 years +/- 8.52 (range 42-80 years). The individual improvement of complaints was assessed by the patients using a percentage scale (0% = no improvement; 100% = no complaints). Objective and subjective improvement was achieved in 26 of 28 patients. The mean subjective improvement was 57.7% +/- 31.4. In 23 cases an additional treatment with botulinum toxin was administered. During follow-up period (mean 22.1 months +/- 11.6; range 5-40 months) the effect of surgery remained stable. There were no serious complications, in a 5 of 56 operated eyes suture granuloma had developed. Unlike other surgeries for treatment of blepharospasm (excision of the orbicularis muscle, resection of facial nerve branches) frontalis suspension can be considered as a minimally invasive, but very effective and (if desired) reversible procedure. Moreover, additional treatment with botulinum toxin can bring about further improvement.
31例患有特发性睑痉挛或提上睑肌抑制型睑裂张开障碍且对肉毒杆菌毒素治疗无反应的患者接受了额肌悬吊术。28例患者接受了双侧手术（3例双侧症状严重程度不同的患者在症状较重的一侧进行手术；这些患者未纳入统计分析）。平均年龄为62.4岁±8.52（范围42 - 80岁）。患者使用百分比量表（0% = 无改善；100% = 无不适）评估个体症状改善情况。28例患者中有26例实现了客观和主观改善。主观改善的平均值为57.7%±31.4。23例患者额外接受了肉毒杆菌毒素治疗。在随访期间（平均22.1个月±11.6；范围5 - 40个月），手术效果保持稳定。未出现严重并发症，56只手术眼中有5只出现了缝线肉芽肿。与其他治疗睑痉挛的手术（眼轮匝肌切除术、面神经分支切除术）不同，额肌悬吊术可被视为一种微创但非常有效且（如有需要）可逆的手术。此外，额外使用肉毒杆菌毒素治疗可带来进一步改善。
