Abstract：
BACKGROUND: Even though upper blepharoplasty is one of the most commonly performed procedures in esthetic surgery, there is still no consensus regarding the management of the orbicularis oculi muscle (OOM).
OBJECTIVE: To compare outcomes of upper eyelid blepharoplasty with or without OOM excision using surface electromyography in a 12 month follow-up.
METHODS: A prospective, randomized, single-blinded comparative split-face study was conducted on 26 patients with dermatochalasis. Skin-only upper blepharoplasty was performed on a randomly selected side, and on the contralateral side, a strip of OOM was resected as well. The functional outcomes were assessed using sEMG, and the esthetics were evaluated independently by the operating surgeon, blinded patients, and three blinded ophthalmic surgeons.
RESULTS: The RMS values of maximal contraction of the OOM were statistically significantly lower two weeks after blepharoplasty than the values before surgery in both groups (p < 0,001) and reached the preoperative values after six months. Lagophthalmos occurred in 2 cases in the skin-muscle group (7.69%), and no incidence of lagophthalmos was observed in the skin group. There were comparable esthetic outcomes on both operated sides.
CONCLUSIONS: This study is an objective and quantitative report using surface electromyography on upper blepharoplasty with or without a strip of OOM excision. Our results showed that OOM fully recovers after the stripping procedure. The resection of the skin-OOM flap showed no difference in long-term cosmetic results. Therefore, we recommend OOM preservation during upper blepharoplasty unless muscle excision is well-grounded.
OBJECTIVE: To compare outcomes of upper eyelid blepharoplasty with or without OOM excision using surface electromyography in a 12 month follow-up.
METHODS: A prospective, randomized, single-blinded comparative split-face study was conducted on 26 patients with dermatochalasis. Skin-only upper blepharoplasty was performed on a randomly selected side, and on the contralateral side, a strip of OOM was resected as well. The functional outcomes were assessed using sEMG, and the esthetics were evaluated independently by the operating surgeon, blinded patients, and three blinded ophthalmic surgeons.
RESULTS: The RMS values of maximal contraction of the OOM were statistically significantly lower two weeks after blepharoplasty than the values before surgery in both groups (p < 0,001) and reached the preoperative values after six months. Lagophthalmos occurred in 2 cases in the skin-muscle group (7.69%), and no incidence of lagophthalmos was observed in the skin group. There were comparable esthetic outcomes on both operated sides.
CONCLUSIONS: This study is an objective and quantitative report using surface electromyography on upper blepharoplasty with or without a strip of OOM excision. Our results showed that OOM fully recovers after the stripping procedure. The resection of the skin-OOM flap showed no difference in long-term cosmetic results. Therefore, we recommend OOM preservation during upper blepharoplasty unless muscle excision is well-grounded.
摘要：
背景：尽管上眼睑成形术是美容手术中最常见的手术之一，关于眼轮匝肌（OOM）的管理仍未达成共识。
目的：在12个月的随访中使用表面肌电图比较有或没有OOM切除的上眼睑眼睑成形术的结果。
方法：前瞻性，随机化，对26例皮肤松弛症患者进行了单盲比较分面研究。在随机选择的一侧进行仅皮肤的上眼睑成形术，在对侧，一条OOM也被切除。使用sEMG评估功能结果，美学由手术外科医生独立评估，失明的病人，和三个失明的眼外科医生。
结果：两组在眼睑成形术后两周，OOM最大收缩的RMS值在统计学上明显低于手术前的值（p<0.001），并在六个月后达到术前值。皮肌组2例(7.69%)发生拉氏眼病,在皮肤组中没有观察到眩眼的发生率。手术双方的美学结果具有可比性。
结论：本研究是使用表面肌电图对上眼睑成形术进行的客观定量报告，无论是否进行OOM切除。我们的结果表明，OOM在剥离程序后完全恢复。皮肤-OOM皮瓣的切除在长期美容效果上没有差异。因此,我们建议在上眼睑成形术期间保留OOM，除非肌肉切除有良好的基础。
目的：在12个月的随访中使用表面肌电图比较有或没有OOM切除的上眼睑眼睑成形术的结果。
方法：前瞻性，随机化，对26例皮肤松弛症患者进行了单盲比较分面研究。在随机选择的一侧进行仅皮肤的上眼睑成形术，在对侧，一条OOM也被切除。使用sEMG评估功能结果，美学由手术外科医生独立评估，失明的病人，和三个失明的眼外科医生。
结果：两组在眼睑成形术后两周，OOM最大收缩的RMS值在统计学上明显低于手术前的值（p<0.001），并在六个月后达到术前值。皮肌组2例(7.69%)发生拉氏眼病,在皮肤组中没有观察到眩眼的发生率。手术双方的美学结果具有可比性。
结论：本研究是使用表面肌电图对上眼睑成形术进行的客观定量报告，无论是否进行OOM切除。我们的结果表明，OOM在剥离程序后完全恢复。皮肤-OOM皮瓣的切除在长期美容效果上没有差异。因此,我们建议在上眼睑成形术期间保留OOM，除非肌肉切除有良好的基础。
