崔子伟, 杨 颖,王卫东,李红艳,何成君

[摘要]目的：探索重睑成形术中内眦赘皮矫正术的新方法。方法：在内眦部位设计矛头状皮肤切口上方与重睑线连接，下方沿下睑延长，水平切断内眦处的眼轮匝肌纤维，横向缩短内眦韧带，将赘皮缘推进缝合至鼻侧切口，消除引起赘皮的解剖学因素。结果：临床应用30例对25例进行了为期1～12个月的随访，结果所有患者的重睑形态满意，内眦矫正充分、瘢痕隐蔽。结论：此方法能充分矫正内眦赘皮，适合于重睑成形术同期施行，是一种操作简单效果满意的方法。

[关键词]重睑成形术；矛头状皮肤切除术；内眦赘皮

[中图分类号]R622[文献标识码]A[文章编号]1008-6455（2012）04-0568-02

Correction of epicanthus by the spearhead excision in double-eyelid blepharoplasty

CUI Zi-wei,YANG Ying,WANG Wei-dong,LI Hong-yan,HE Cheng-jun

(Department of Plastic&Cosmetic Surgery,Daqing Oilfield General Hospital,Daqing 163001,Helongjiang,China）

Abstract:ObjectiveTo explore a new method to perform the medial canthoplasty combined with the double-eyelid blepharoplasty in a single procedure.MethodsA spearhead incision was designed at the medial canthus,the upper side of the incision was connected with the line of the double-eyelid, the inferior side of the incision was extended along the lower palpebral edge,the obcular muscle of medial canthus was horizontally dissected,then the medial canthal ligament was shorted flatly,the edge of epicanthus was advanced to the inner sidepiece,the abnormal factors in anatomy were eliminated.Results25 cases of 30 patients had been followed up from 1 month to12 months. All patients achieved satisfactory aesthetic results.The epicanthus was corrected completely without the evident scars.ConclusionsThis is a simple and satisfactory method for epicanthus with double-eyelid blepharoplasty.

Key words:double-eyelid blepharoplasty;spear shape excision;epicanthus

东方人常有先天性内眦赘皮，如不处理将影响重睑术的美容效果[1]。很多学者提出了行重睑术同时矫正内眦赘皮的方法，主要有，“Z”成形术和改良的“Z”成形术[2-3]；“V-Y”成形术[2,4]；“L”形和Mustarde内眦赘皮矫正术等[2]，均取得了一定的治疗效果。笔者受矛头状皮肤切除术矫正外眦钝圆[5]的启发，在重睑成形术中行矛头状皮肤切除术矫正内眦赘皮，自2007年10月至2008年10月临床应用30例，取得了良好效果。

1资料和方法

1.1 临床资料：本组共30例，男5例，女25例，年龄18～42岁，平均25岁。

1.2 手术方法

1.2.1 手术设计：在内眦部位定出正常内眦点A，标记赘皮缘全长BC，连接AB和AC，将AC沿下睑缘向外侧延长，通常延长1～1.5cm，ABC围成的矛头状皮肤在术中切除，距睑缘6～8mm画重睑成形术切口线，内侧端与B点相连。根据情况画出上睑应当切除的皮肤量（图1）。

1.2.2 手术步骤： 1%利多卡因加1∶200 000肾上腺素行局部浸润麻醉。……