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額前肌瓣前移術用於眼瞼下垂之矯正
Frontalis Muscle Flap Advancement for Correction of Ptosis
摘要
目的：介紹一種不需要使用體外人工材料，而是利用額前肌瓣前移來矯正先天性或後天性眼瞼下垂之手術。 方法：我們共收集了7個病例，進行了單側之額前肌瓣前移術。其中眼瞼下垂的原因：6例為先天性眼瞼下垂，1例為第三對腦神經麻痺性眼瞼下垂。7位病例中6位術前之提眼瞼肌功能小於6公屋。 手術方法：在上眼瞼摺痕處及眉毛之上緣各切一水平切口，上眼瞼處向內分到眼瞼板之深度；在眉毛上緣處向內分至額前肌，分出一條約1公分寬度之額前肌瓣，將此一肌瓣穿過環眼輪肌之下方，帶至眼瞼板之上緣，以5-O polyester因定。 結果：7位病例當中有6位病例在初次手術矯正後都得到良好的結果。術後追蹤的時間由3到78個月不等。術後的併發症，包括暫時性眼瞼閉合不全7例，暫時性角膜表皮糜爛5例，矯正不足1例。 結論：額前肌瓣前移術是直接將額前肌之肌止端轉移到眼瞼板，作為懸吊之材料，以及直接利用額前肌之收縮力量作用於下垂的眼瞼將之提起，可以有效的矯正眼瞼下垂，是州固成功率高且併發症少之手術方法，術後的眼瞼輪廓也令人滿意。
關鍵字
無資料並列摘要
Purpose: To introduce a technique of frontalis muscle advancement to correct congenital or acquired ptosis instead of using a graft or suture material. Method: We collected 7 patients with ptotic eyelids who had undergone correction with the frontalis muscle advancement technique. The etiologies of ptosis were congenital ptosis (6 cases). and CN Ⅲ palsy (1 case). Six patients had poor pre-op levator function (＜6mm). From an incision of the upper border of the eyebrow we created a frontalis muscle strip about 1 cm in width, which was then brought down through the subcutaneous tunnel between brow incision and the upper lid crease incision, and was fixed to the upper border of the tarsus with 5-O polyester. Result: There were 6 cases adequately corrected after initial operation. The follow-up intervals range from 3-78 months. Complications were few, including transient lagophthalmos (7 cases), transient corneal erosion (5 cases), and under-correction (1 case). Conclusion: Frontalis muscle advancement is a technique to relocate the insertion of frontalis muscle to the eyelid and let the eyelid to be elevated by direct frontalis muscle action, which has a high success rate with few post-operative complications. Most patients had good postoperative satisfactory eyelid contour.