눈꺼풀 처짐 수술과 쌍꺼풀 동시 수술 시 눈꺼풀 올림근기능에 따른 쌍꺼풀 변화
Double Fold Affected by Levator Function in Simultaneous Double Eyelid Blepharoplasty with Blepharoptosis Surgery
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목적: 눈꺼풀 처짐 환자에서 눈꺼풀 처짐과 쌍꺼풀을 동시 수술 시 눈꺼풀 올림근의 기능에 따른 쌍꺼풀 변화를 알아보고자 하였다. 대상과 방법: 2006년 1월부터 2010년 2월까지 눈꺼풀 처짐 수술과 쌍꺼풀 수술을 동시에 받은 206명 400안을 대상으로 후향적 의무기록 조사를 하였다. 수술 전 Levator Function Test (LFT)≤5 mm이면 Group A (82안), LFT: 6-9 mm이면 Group B (115안), LFT≥10mm이면 Group C (203안)로 각각 나누었다. 각 군별로 수술 전 MRD1, 수술 방법, 술 후 쌍꺼풀 크기 및 대칭성 여부, 재수술에 관하여알아보았다. 결과: 모든 군에서 가장 많이 시행한 눈꺼풀 처짐 수술 방법은 눈꺼풀 올림근 절제술이었다. 그리고 비대칭적인 쌍꺼풀 발생의 가장흔한 원인은 눈꺼풀 처짐 저교정이었다. 눈꺼풀 올림근의 기능이 떨어질수록 눈꺼풀 처짐 저교정이 많이 발생하였으며, 각 군 간의통계학적으로 유의한 차이를 보였다(p=0.006). 다른 원인으로는 피부 늘어짐의 차이, 과도한 눈썹 올림, 쌍꺼풀의 풀림, 눈꺼풀 처짐과교정에 의해서도 쌍꺼풀 높이가 비대칭적으로 발생하였다. 결론: 눈꺼풀 처짐 수술과 쌍꺼풀 동시 수술 시 눈꺼풀 처짐 저교정이 쌍꺼풀 높이 변화의 가장 흔한 원인이었으며 눈꺼풀 올림근의기능이 떨어질수록 눈꺼풀 처짐의 재발이 흔하다. 따라서 눈꺼풀 기능이 좋지 않은 눈에서 쌍꺼풀은 정상적인 높이보다 낮게 해야하며, 비대칭적인 쌍꺼풀 발생에 영향을 주는 다양한 인자들을 고려해야 한다.
Abstract
Purpose: To evaluate height and symmetry of double folds following simultaneous levator palpebral muscle resection and doubleeyelid blepharoplasty for correction of blepharoptosis. Methods: We retrospectively studied 400 eyes of 286 patients who underwent simultaneous surgeries for double eyelid constructionand correction of blepharoptosis from January 2006 to December 2011. All the patients were divided into three groupsbased on levator palpebrae muscle function: group A consisted of 82 eyes whose Levator Function Test (LFT) was 5 cm or less,group B consisted of 115 eyes whose LFT was between 5 and 10 cm, group C consisted of 203 eyes whose LFT was over 10 cm. For each group, we evaluated the preoperative marginal reflex distance 1 (MRD1), surgical methods, the postoperative heightand symmetry of the double folds, and additional operations for correcting blepharoptosis. Results: Blepharoptosis surgery was performed in all groups by simultaneous levator resection and double eyelid blepharoplastyin all groups. Postoperative asymmetric double fold was the most common outcome observed in the poor levator functiongroup A. Blepharoptosis under-correction was the most common cause of asymmetric double fold and its occurrence was statisticallydifferent between the three groups. The other causes were skin redundancy, brow elevation, double fold loosening, andblepharoptosis over-correction. Conclusions: The height of a double eyelid can be changed postoperatively by changing levator palpebrae muscle function. Incases of poor levator function, the levator palpebrae muscle is positioned slightly lower than the normal double fold. This conditionmay result in further relapse or recurrence in the poor levator function group. Also, levator function should be consideredamong the diverse factors that determine the height of the double fold.
참고문헌 (14)
- Park DH, "Strategies for simultaneous double eyelid blepharoplasty in Asian patients with congenital blepharoptosis", Aesthetic Plast Surg, 32, pp.66~71 (2008)
- Morax S, "Complications of blepharoplasty", Orbit, 25, pp.303~318 (2006)
- Park DH, "Recurrence of blepharoptosis after a superiorly based muscle flap: treatment by frontalis muscle advancement", Plast Reconstr Surg, 116, pp.1954~1959 (2005)
- Al-Mujaini A, "Total levator aponeurosis resection for primary congenital ptosis with very poor levator function", Oman J Ophthalmol, 3, pp.122~125 (2010)
- Yoon JS, "Long-term functional and cosmetic outcomes after frontalis suspension using autogenous fascia lata for pediatric congenital ptosis", Ophthalmology, 116, pp.1405~1414 (2009)
- Tucker SM, "Stabilization of eyelid height after aponeurotic ptosis repair", Ophthalmology, 106, pp.517~522 (1999)
- BERKE RN, "Results of resection of the levator muscle through a skin incision in congenital ptosis", AMA Arch Ophthalmol, 61, pp.177~201 (1959)
- Beard C, "The surgical treatment of blepharoptosis: a quantitative approach", Trans Am Ophthalmol Soc, 64, pp.401~487 (1966)
- Doxanas MT, "Simplified aponeurotic ptosis surgery", Ophthalmic Surg, 23, pp.512~515 (1992)
- Berlin AJ, "Levator aponeurosis surgery. A retrospective review", Ophthalmology, 96, pp.1033~1036 (1989)
- Zhou Q, "Preoperative asymmetry of upper eyelid thickness in young Chinese women undergoing double eyelid blepharoplasty", J Plast Reconstr Aesthet Surg, 65, pp.1175~1180 (2012)
- Chen SH, "Strategies for a successful corrective Asian blepharoplasty after previously failed revisions", Plast Reconstr Surg, 114, pp.1270~1277 (2004)
- Wu S, "Combined anchor suture with external upper eyelid blepharoplasty in Asian patients", Arch Facial Plast Surg, 12, pp.230~234 (2010)
- Starck WJ, "Objective evaluation of the eyelids and eyebrows after blepharoplasty", J Oral Maxillofac Surg, 54, pp.297~302 (1996)