上睑下垂患者提上睑肌肌力与术后眼睑闭合的相关性

doi:10.6040/j.issn.1673-3770.0.2023.443

摘要/Abstract

摘要： 目的探讨先天性上睑下垂患者术前提上睑肌肌力与术后眼睑闭合的相关性,为临床不同肌力上睑下垂的手术方式选择和预后判断提供参考依据。方法纳入先天性上睑下垂患者83例122眼,行提上睑肌缩短术或额肌瓣悬吊术,测量术前提上睑肌肌力和术后第1 d、7 d、1个月、3个月、6个月的眼睑闭合情况,分别对两种术式提上睑肌肌力与术后眼睑闭合之间的相关性进行分析研究。结果提上睑肌缩短术术前提上睑肌肌力与术后眼睑闭合不全测量值之间呈负相关(r=-0.330 1,P<0.01),术前肌力越好,术后眼睑闭合不全测量值越低;额肌瓣悬吊术不具有相关性(r=-0.229 1,P=0.125 7)。两种术式均为术后时间越长,眼睑闭合不全测量值越小,提上睑肌缩短术后3个月闭合,额肌瓣悬吊术后6个月仍有部分未闭合。结论提上睑肌缩短术术前提上睑肌肌力与术后眼睑闭合有关,肌力越好,闭合程度越好,所需时间越短。额肌瓣悬吊术术前提上睑肌肌力与术后眼睑闭合无关。提上睑肌缩短术闭合早,提上睑肌缩短术为更优选择。

关键词: 先天性上睑下垂, 提上睑肌缩短术, 额肌瓣悬吊术, 提上睑肌肌力, 眼睑闭合, 相关性

Abstract: Objective To investigate the correlation between the strength of the levator palpebrae superioris muscle and postoperative eyelid closure in patients with congenital blepharoptosis, aiming to provide a reference basis for surgical method selection and prognosis assessment in clinical practice. Methods A total of 122 eyes from 83 patients with congenital blepharoptosis were included in this study. Surgical procedures involved either shortening of the levator palpebrae superioris muscle or frontalis muscle flap suspension. Prior to surgery, the muscle strength of the levator palpebrae superioris was measured and recorded. Subsequently, eyelid closure was assessed on postoperative day one, day seven, month one, month three, and month six for patients who underwent the same surgical procedure. The correlation between preoperative muscle strength of the levator palpebrae superioris and postoperative eyelid closure was analyzed. Results The strength of the levator palpebrae superioris muscle exhibits a negative correlation with the degree of postoperative eyelid closure insufficiency in patients with shortening of the levator palpebrae superioris muscle(r=-0.330 1, P<0.01). However, no significant correlation was observed in cases involving frontalis muscle flap suspension operation(r=-0.229 1, P=0.125 7). The longer the postoperative time, the smaller the eyelid closure insufficiency in both surgical methods. After a 3-month shortening of the levator palpebrae superioris muscle, complete eyelid closure was achieved. However, even after a 6-month frontalis muscle flap suspension, partial non-closure still persisted. Conclusion The robustness of the muscle plays a crucial role in achieving proficient eyelid closure post-operatively following levator palpebrae muscle shortening surgery. A stronger muscle results in enhanced closure and reduced closure time. In contrast, the strength of the upper eyelid muscle has minimal significance for eyelid closure post-operatively during frontal muscle flap suspension surgery. Levator palpebrae muscle shortening surgery facilitates earlier eyelid closure post-operatively, making it the optimal choice.

Key words: Congenital Blepharoptosis, Shortening of the levator palpebrae superioris muscle, Frontalis muscle flap suspension operation, Muscle strength of the levator palpebrae superioris, Closure of eyelids, Correlation

中图分类号:

R765.21

刘欣,杜安石,王艳,谭青青,李俊萍,郭玉楠,兰长骏. 上睑下垂患者提上睑肌肌力与术后眼睑闭合的相关性[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 70-75.

LIU Xin, DU Anshi, WANG Yan, TAN Qingqing, LI Junping, GUO Yunan, LAN Changjun. Investigation of the correlation between levator palpebrae superioris muscle strength and postoperative eyelid closure in patients with blepharoptosis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(5): 70-75.

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