Frontalis suspension

额骨悬吊
  • 文章类型: Journal Article
    上眼睑是一种位置异常低的上眼睑。管理取决于严重程度,病因学,和提上掌肌(LPS)的功能。这篇综述评估了自体筋膜吊索(AFLS)在上睑下垂手术治疗中的成功。并发症和再手术/翻修率。在PubMed上进行了文献检索,谷歌学者PROSPERO,dynamed,DARE,EMBASE,科克伦,和BMJ数据库(PROSPERO注册:CRD42023475090),纳入30项研究(3690例患者和5059只眼)。患者的平均年龄为14.2岁,男女比例为1:0.7。共有2532只眼进行了带自体筋膜的筋膜吊带。平均随访时间32.6个月。筋膜吊带手术的反射距离1(MR1)边缘改善为2.79mm。涉及自体阔筋膜的手术并发症发生率为21.3%。最常见的并发症包括眩眼(19.8%),残余下垂(11.5%),和角膜损伤(10.4%)。再次手术率为13.4%。再手术最常见的适应症是美容,不对称(18%),眼睑折痕异常(30%),和上眼睑修剪(18%)。AFLS患者的总并发症发生率为20%(95%CI:6至35,p<0.01;I2=89%),而非AFLS患者为27%(95%CI:14至40,p<0.01;I2=90%)。AFLS在上睑下垂的手术治疗中是谨慎的。这篇综述的结果表明,与其他传统技术相比,它们的使用与相似的并发症发生率相关,但重复手术较少。上眼睑是一种位置异常低的上眼睑。管理取决于严重程度,病因学,和提上掌肌(LPS)的功能。这篇综述评估了自体筋膜吊索(AFLS)在上睑下垂手术治疗中的成功。并发症和再手术/翻修率。在PubMed上进行了文献检索,谷歌学者PROSPERO,dynamed,DARE,EMBASE,科克伦,和BMJ数据库(PROSPERO注册:CRD42023475090),纳入30项研究(3690例患者和5059只眼)。患者的平均年龄为14.2岁,男女比例为1:0.7。共有2532只眼进行了带自体筋膜的筋膜吊带。平均随访时间32.6个月。筋膜吊带手术的反射距离1(MR1)边缘改善为2.79mm。涉及自体阔筋膜的手术并发症发生率为21.3%。最常见的并发症包括眩眼(19.8%),残余下垂(11.5%),和角膜损伤(10.4%)。再次手术率为13.4%。再手术最常见的适应症是美容,不对称(18%),眼睑折痕异常(30%),和上眼睑修剪(18%)。AFLS患者的总并发症发生率为20%(95%CI:6至35,p<0.01|上眼睑异常低位。管理取决于严重程度,病因学,和提上掌肌(LPS)的功能。这篇综述评估了自体筋膜吊索(AFLS)在上睑下垂手术治疗中的成功。并发症和再手术/翻修率。在PubMed上进行了文献检索,谷歌学者PROSPERO,dynamed,DARE,EMBASE,科克伦,和BMJ数据库(PROSPERO注册:CRD42023475090),纳入30项研究(3690例患者和5059只眼)。患者的平均年龄为14.2岁,男女比例为1:0.7。共有2532只眼进行了带自体筋膜的筋膜吊带。平均随访时间32.6个月。筋膜吊带手术的反射距离1(MR1)边缘改善为2.79mm。涉及自体阔筋膜的手术并发症发生率为21.3%。最常见的并发症包括眩眼(19.8%),残余下垂(11.5%),和角膜损伤(10.4%)。再次手术率为13.4%。再手术最常见的适应症是美容,不对称(18%),眼睑折痕异常(30%),和上眼睑修剪(18%)。AFLS患者的总并发症发生率为20%(95%CI:6至35,p<0.01;I=89%),而非AFLS患者为27%(95%CI:14至40,p<0.01;I2=90%)。AFLS在上睑下垂的手术治疗中是谨慎的。这篇综述的结果表明,与其他传统技术相比,它们的使用与相似的并发症发生率相关,但重复手术较少。上眼睑是一种位置异常低的上眼睑。管理取决于严重程度,病因学,和提上掌肌(LPS)的功能。这篇综述评估了自体筋膜吊索(AFLS)在上睑下垂手术治疗中的成功。并发症和再手术/翻修率。在PubMed上进行了文献检索,谷歌学者PROSPERO,dynamed,DARE,EMBASE,科克伦,和BMJ数据库(PROSPERO注册:CRD42023475090),纳入30项研究(3690例患者和5059只眼)。患者的平均年龄为14.2岁,男女比例为1:0.7。共有2532只眼进行了带自体筋膜的筋膜吊带。平均随访时间32.6个月。筋膜吊带手术的反射距离1(MR1)边缘改善为2.79mm。涉及自体阔筋膜的手术并发症发生率为21.3%。最常见的并发症包括眩眼(19.8%),残余下垂(11.5%),和角膜损伤(10.4%)。再次手术率为13.4%。再手术最常见的适应症是美容,不对称(18%),眼睑折痕异常(30%),和上眼睑修剪(18%)。AFLS患者的总并发症发生率为20%(95%CI:6至35,p<0.01;I2=89%),而非AFLS患者为27%(95%CI:14至40,p<0.01;I2=90%)。AFLS在上睑下垂的手术治疗中是谨慎的。这篇综述的结果表明,与其他传统技术相比,它们的使用与相似的并发症发生率相关,但重复手术较少。I2=90%)在非AFLS患者中。AFLS在上睑下垂的手术治疗中是谨慎的。这篇综述的结果表明,与其他传统技术相比,它们的使用与相似的并发症发生率相关,但重复手术较少。|上眼睑是一种异常低的上眼睑。管理取决于严重程度,病因学,和提上掌肌(LPS)的功能。这篇综述评估了自体筋膜吊索(AFLS)在上睑下垂手术治疗中的成功。并发症和再手术/翻修率。在PubMed上进行了文献检索,谷歌学者PROSPERO,dynamed,DARE,EMBASE,科克伦,和BMJ数据库(PROSPERO注册:CRD42023475090),纳入30项研究(3690例患者和5059只眼)。患者的平均年龄为14.2岁,男女比例为1:0.7。共有2532只眼进行了带自体筋膜的筋膜吊带。平均随访时间32.6个月。筋膜吊带手术的反射距离1(MR1)边缘改善为2.79mm。涉及自体阔筋膜的手术并发症发生率为21.3%。最常见的并发症包括眩眼(19.8%),残余下垂(11.5%),和角膜损伤(10.4%)。再次手术率为13.4%。再手术最常见的适应症是美容,不对称(18%),眼睑折痕异常(30%),和上眼睑修剪(18%)。AFLS患者的总并发症发生率为20%(95%CI:6至35,p<0.01;I2=89%),而非AFLS患者为27%(95%CI:14至40,p<0.01;I2=90%)。AFLS在上睑下垂的手术治疗中是谨慎的。这篇综述的结果表明,与其他传统技术相比,它们的使用与相似的并发症发生率相关,但重复手术较少。
    Ptosis is an abnormally low-positioned upper eyelid. Management depends on severity, aetiology, and function of the levator palpebrae superioris muscle (LPS). This review evaluates the success of autogenous fascia lata slings (AFLS) in the surgical management of ptosis, together with complication and reoperation/revision rates. A literature search was conducted on PubMed, Google Scholar PROSPERO, Dynamed, DARE, EMBASE, Cochrane, and BMJ databases (PROSPERO registration: CRD42023475090), and 30 studies (3690 patients and 5059 eyes) were included. The average age of the patients was 14.2 years with a ratio of male:female patients of 1:0.7. A total of 2532 eyes had undergone a fascial sling with autogenous fascia lata. The average follow-up period was 32.6 months. Improvement in the margin to reflex distance 1 (MRD1) with fascial sling surgery was 2.79 mm. The rate of complications from surgery involving autogenous fascia lata was 21.3%. The most common complications included lagophthalmos (19.8%), residual ptosis (11.5%), and corneal damage (10.4%). The reoperation rate was 13.4%. Most common indications for reoperation were cosmetic, with asymmetry (18%), lid crease abnormalities (30%), and upper eyelid trimming (18%). The overall complication rate in AFLS patients was 20% (95% CI: 6 to 35, p < 0.01; I2 = 89%) versus 27% (95% CI: 14 to 40, p < 0.01; I2 = 90%) in non-AFLS patients. AFLSs are prudent in the surgical management of ptosis. The results of this review demonstrate that their use is associated with similar complication rates but fewer reoperations than other traditional techniques.
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  • 文章类型: Journal Article
    BACKGROUND: Several treatments have been described for the treatment of congenital ptosis, but there are few studies that analyze the effectiveness of a therapeutic approach rather than a single technique.
    OBJECTIVE: In this study, we aim to evaluate the effectiveness of our therapeutic algorithm, which relies on levator muscle resection and frontalis suspension with silicone rods, polytetrafluoroethylene (PTFE), or autologous fascia lata.
    METHODS: We retrospectively analyzed all patients affected by congenital ptosis who underwent corrective surgery at a single department between January 1998 and January 2016.
    RESULTS: A total of 116 procedures were performed in 86 patients, accounting for 35 levator resections, 67 frontalis suspensions, and 14 revisions. A satisfactory result was observed in 65 cases after one procedure (75.6%). Complications occurred in 13 cases after primary surgery (15.1%). Ptosis relapse was observed in 25 cases after primary procedure (21.5%). Frontalis suspension displayed a higher number of complications than levator resection (22.2% vs 3.1%, p=0.02).
    CONCLUSIONS: Our therapeutic algorithm was effective in 75.6% after one procedure. Frontalis suspension procedures encountered a higher rate of complication than levator resection. Fascia lata should be preferred to silicon rods whenever possible due to the lower recurrence rate. These issues confirm the therapeutic algorithm, although larger prospective studies are necessary to validate our approach.
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