Classification And The Surgical Correction Of Epicanthus And Its Long-term Follow-up

The medial epicanthal fold is formed by an excess of skin that lies in a vertical,semilunar orientation, located at the medial canthus and overlying the medial canthalstructures. It has close relationship with racial difference. It exists in Mongolian inCentral Asia, North Asia and East Asia mostly, so it is also called "mongoloid fold". Itexists in more than one half of the Chinese and in 50 to 90 percent of Koreans andJapanese. And more than 70 percent of foldless eyelid combines the medialepicanthal fold. The characteristics are that the medial canthal corner is often coveredby the epicanthus. The severe epicanthal fold hides part of the sight, which looks likepseudoesotropia in appearance, makes the palpebral fissure shorter, and makes themedial canthal distance longer. If the double eyelid exists with the epicanthus, theepicanthus will make the double eyelid "semi-double" in appearance, which is anunpleasant look.This thesis is composed of two parts: reviewing the literature on the formationand the surgical correction of the epicanthus and the clinical application of theepicanthoplasties with their long-term follow-up.In our summary, we reviewed the literature and summarized the correspondinganatomical studies, the formation cause of epicanthus, the classification andgraduation of epicanthus, varied methods to correct the epicanthic fold. And especially,the newest progression and the prospective of above-motioned aspects in recent yearswere discussed in our summary.On the basis of the investigation on the 1370 cases of epicanthi that weretreated in late 8 years, the relationship between the epicanthal appearances andanatomical dissection in surgery was summarized. All the epicanthi were corrected byZhang's procedure, Park's procedure or Mustarde's procedure, or with a concomitantdouble eyelidplasty. 294 cases were followed up in long-term and the follow-up timewas 6 months to 38 months. According to the epicanthal formation, they wereclassified into three types: upper-eyelid type (corrected by Zhang's or Park'sprocedure), lower-eyelid type (corrected by Mustarde's or Park's procedure), or upper-lower-eyelid type (corrected by Zhang's or Park's procedure). According to thedegrees to cover the carruncula, the epicanthi were divided into the mild, the moderateor the serious. 294 cases were followed up in long-term time from 6 months to 38months, of which, 264 cases were corrected completely and 30 cases were correctedincompletely. The incision scar faded 2-6 months later. The appearance of the medialcanthi and the double eyelids were natural.