What is levator palpebrae superioris shortening?
Shortening levator palpebrae superioris muscle is one of the commonly used methods to correct ptosis. The main method is to open the upper eyelid tissue by surgery, separate and remove some tissues and suture them to shorten the contraction of levator palpebrae superioris. Let the eyes of people with congenital moderate and mild ptosis be more divine, and no longer be troubled by small eyes.
Definition: Under normal circumstances, we call the difficulty of eyelid lifting caused by muscle weakness of levator palpebrae superioris ptosis, which is generally divided into mild, moderate and severe.
Judging criteria: when looking forward, if the eyelid margin covers the upper edge of the pupil, this situation is mild; If the upper third of the pupil is covered, this situation is moderate; If half of the pupils are covered, then this situation is serious.
Indications for shortening levator palpebrae superioris muscle
The indication of shortening levator palpebrae superioris is mild or moderate congenital ptosis, and levator palpebrae superioris still has certain functions (not suitable for severe ptosis, generally less than 5mm is severe ptosis). In addition, levator palpebrae superioris muscle is also suitable for acquired aponeurosis ptosis.
Will levator palpebrae superioris muscle shorten and recur?
There was no recurrence after levator palpebrae superioris operation. The reason why levator palpebrae superioris surgery can't rebound or decline is mainly because levator palpebrae superioris surgery changes the tissue of levator palpebrae superioris irreversibly, so it won't rebound after levator palpebrae superioris surgery.
Shortening levator palpebrae superioris operation
Firstly, a new incision line of double eyelid was designed according to the method of double eyelid plasty. The widest part of the standard double eyelid (the junction of double eyelid line 1/3) should be 6 ~ 8 mm According to the patient's eye shape, a new double eyelid shape (parallel, open or meniscus) should be designed under the original deformed double eyelid incision stitch. The scar of the original double eyelid line should be treated according to the situation. If the skin is slack, the scar of the surgical incision can be removed together with the excess skin, so that the upper eyelid ectropion does not occur.
1. Use 5ml of 2% lidocaine, 5ml of normal saline and 0.1:1mg of epinephrine for local infiltration anesthesia before the upper eyelid plate.
2. Cut the skin along the new double eyelid line, and determine the width of the skin above the new double eyelid line according to the relaxation degree of the upper eyelid skin of the patient.
3. For the double eyelid with obvious scar adhesion, the original scar should be removed, and the adhesion between the original double eyelid line and the tarsal plate should be fully relieved, so that the tissue layer can be dissected clearly and cannot be adhered to each other.
4. Find levator palpebrae superioris muscle and fold and sew its aponeurosis (7-0 nylon thread). The folding length is determined by the extent to which the eyelid margin does not exceed the corneal margin. This method makes the eyelid margin move up, which can improve the phenomenon of mild ptosis and eye weakness.
5. Free the orbicularis oculi muscle completely, and move it down to the upper eyelid fold for suture.
6. If the soft tissue is insufficient, the surrounding soft tissue such as orbital septum fat can be transplanted to fill the original double eyelid depression and fixed with 7-0 nylon thread. This not only eliminates the adhesion of the original double eyelid incision, but also restores the continuity of orbicularis oculi muscle under the original incision.