Junhu Shi, Zhaochuan Liu, Yadi Li, Lihua Song, Yan Li, Jianwei Yang, Runhui Pang, Hongbin Zhang, Li Xiao, Ping Bai
{"title":"Efficacy of Combined Conjoint Fascial Sheath and Levator Muscle Composite Flap Suspension for Congenital Severe Ptosis.","authors":"Junhu Shi, Zhaochuan Liu, Yadi Li, Lihua Song, Yan Li, Jianwei Yang, Runhui Pang, Hongbin Zhang, Li Xiao, Ping Bai","doi":"10.1097/PRS.0000000000010947","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Conjoint fascial sheath (CFS) suspension has been gradually recognized and accepted for the treatment of congenital severe blepharoptosis in recent years. To address the problem of postoperative upper eyelid position regression of only CFS suspension, the authors designed and implemented a CFS combined levator muscle (LM) complex flap, and analyzed the surgical efficacy of CFS with LM (CFS+LM) compared with frontalis myofascial flap (FMF) suspension surgery.</p><p><strong>Methods: </strong>Patients diagnosed with congenital severe ptosis and LM function of 4 mm or less were enrolled. The patients were assigned to either the CFS+LM group or the FMF group, to compare and statistically analyze the postoperative effects of CFS+LM versus FMF suspension.</p><p><strong>Results: </strong>Data from 182 patients (220 eyes) were collected in this study, including 89 patients (103 eyes) in the CFS+LM group and 93 patients (117 eyes) in the FMF group. The full correction rate, patient satisfaction, postoperative upper eyelid excursion, and lagophthalmos in the CFS+LM group were significantly better than those in the FMF group. The eyelid retraction rate was significantly higher in the FMF group than in the CFS+LM group. The complication rate in the CFS+LM group was significantly lower than that in the FMF group.</p><p><strong>Conclusions: </strong>CFS+LM suspension had better outcomes than FMF suspension. Considering that the CFS tissue could be weak in patients younger than 5 years and have poor muscle elasticity in patients with LM function less than or equal to 1 mm, FMF suspension is recommended first. For patients older than 5 years with severe ptosis, CFS+LM suspension is recommended.</p><p><strong>Clinical question/level of evidence: </strong>Therapeutic, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"865e-873e"},"PeriodicalIF":3.2000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512606/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Plastic and reconstructive surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PRS.0000000000010947","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/7/25 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Conjoint fascial sheath (CFS) suspension has been gradually recognized and accepted for the treatment of congenital severe blepharoptosis in recent years. To address the problem of postoperative upper eyelid position regression of only CFS suspension, the authors designed and implemented a CFS combined levator muscle (LM) complex flap, and analyzed the surgical efficacy of CFS with LM (CFS+LM) compared with frontalis myofascial flap (FMF) suspension surgery.
Methods: Patients diagnosed with congenital severe ptosis and LM function of 4 mm or less were enrolled. The patients were assigned to either the CFS+LM group or the FMF group, to compare and statistically analyze the postoperative effects of CFS+LM versus FMF suspension.
Results: Data from 182 patients (220 eyes) were collected in this study, including 89 patients (103 eyes) in the CFS+LM group and 93 patients (117 eyes) in the FMF group. The full correction rate, patient satisfaction, postoperative upper eyelid excursion, and lagophthalmos in the CFS+LM group were significantly better than those in the FMF group. The eyelid retraction rate was significantly higher in the FMF group than in the CFS+LM group. The complication rate in the CFS+LM group was significantly lower than that in the FMF group.
Conclusions: CFS+LM suspension had better outcomes than FMF suspension. Considering that the CFS tissue could be weak in patients younger than 5 years and have poor muscle elasticity in patients with LM function less than or equal to 1 mm, FMF suspension is recommended first. For patients older than 5 years with severe ptosis, CFS+LM suspension is recommended.
Clinical question/level of evidence: Therapeutic, III.
期刊介绍：
For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis.
Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
