对于整形外科医生来说,过度近视的外科治疗具有挑战性,和有限的长期结果数据可用。这项长期研究的目的是报告单外科医生的经验,该经验具有分阶段的重建方案,用于矫正过度端粒。
这项回顾性研究回顾了1978年至2000年间由一名外科医生手术治疗的高血压患者的记录。根据患者特定的手术方案进行骨(眼眶盒截骨术和正颌手术)和软组织(鼻成形术和外皮成形术)手术。纳入的患者根据他们在眼眶复位时的年龄分为儿童期组和青春期或成年期组(≤12岁和>12岁,分别)。2020年2月,患者被邀请进行临床访谈,以评估是否提出了翻修手术的要求。在术前和术后长期时间计算基于摄影测量分析的远距指数。对长期结果的满意度由外科专业人员和外行人判断。
总共,包括14例不同病因的高血压患者,在平均29年的随访期间,没有要求进行翻修手术。术前听力亢进指数高于术后远期评估(均,P<0.05)适用于儿童期和青春期或成年期组。组间比较显示,对长期结局分析的超端化指数和基于小组评估的满意度没有显着差异(所有,P>0.05)。
考虑到软组织和骨畸形的复杂性和广泛的临床表现和目前的结果,对这些患者的手术方法应分阶段进行和个性化,以实现功能之间的平衡结果(眼眶,遮挡,和社会心理)和美学参数。
The surgical management of
hypertelorism is challenging for plastic surgeons, and limited long-term outcome data are available. The purpose of this long-term
study was to report a single-surgeon experience with a staged reconstructive protocol for
hypertelorism correction.
This retrospective
study reviewed the records of patients with
hypertelorism who were surgically managed by a single surgeon between 1978 and 2000. Bone (orbital box osteotomy and orthognathic surgery) and soft tissue (rhinoplasty and epicanthoplasty) surgeries were performed based on a patient-specific surgical protocol. Included patients were divided into a childhood group and an adolescence or adulthood group according to their age at orbital repositioning (≤12 and >12 years, respectively). Patients were invited for clinical interviews in February 2020 to evaluate whether requests for revision surgery had been made. The photogrammetric analysis-based hypertelorism index was calculated at preoperative and long-term postoperative times. Satisfaction with the long-term outcome was judged by both surgical professionals and laypeople.
In total, 14 patients with hypertelorism of different etiologies were included, with no request for revision surgery during an average follow-up of 29 years. The preoperative
hypertelorism index was higher than the long-term postoperative evaluation (all, P < 0.05) for both childhood and adolescence or adulthood groups. Intergroup comparison revealed no significant difference for the hypertelorism index and panel assessment-based satisfaction with long-term outcome analysis (all, P > 0.05).
Considering the complexity and wide spectrum of clinical presentation of soft tissue and bone deformities in hypertelorism and current outcomes, the surgical approach to these patients should be staged and individualized for achievement of a balanced result between functional (orbital, occlusion, and psychosocial) and aesthetic parameters.