A Study Of The Clinical Application Of Z-plasty Combining With Orbicularis Oculi Muscle Resection For Epicanthal Fold Correction

Objective: To explore the clinical effect of Z-plasty combining with orbicularis oculi muscle resection for epicanthal fold correction.Methods: 47 cases(44 female, 3 male) of epicanthus patients which were treated by the department of plasty, the 1st Hospital of Jilin University between December, 2013 and May, 2015 were divided into two groups. Among them, 23 patients received traditional medial epicanthoplasty(Group A), and 24 patients received medial epicanthoplasty using the orbicularis oculi muscle resection technique(Group B). The Horizontal Lid Fissure Length(HLFL) and Intercanthal Distance(ICD) were measured preoperatively and postoperatively, with the ratio of Horizontal Lid Fissure Length to Intercanthal Distance(HLFL/ICD) calculated. The ratio and its improvement of each group preoperatively and postoperatively, as well as the difference between two groups, were analyzed with the statistical software IBM SPSS statics 23.Results: In Group A, the average of Intercanthal Distance decrease from(38.8±1.06) mm preoperatively to(33.7±0.93) mm postoperatively; The average of Horizontal Lid Fissure Length increased significantly from(24.9±1.27)mm to(29.6±0.63)mm(P<0.001). But in GroupⅡ, the average of Intercanthal Distance decreased significantly, from a mean of(38.7±1.30)mm preoperatively to(32.2±1.13)mm postoperatively; The average of Horizontal Lid Fissure Length increased significantly from(24.5±1.72)mm to(30.6±1.08)mm(P <0.001). In this study, the ratio of Horizontal Lid Fissure Length to Intercanthal Distance was 0.88±0.03 postoperatively in Group A and 0.95±0.04 in Group B(P<0.001). The improvement of the ratio of Horizontal Lid Fissure Length to Intercanthal Distance was 0.237±0.054 postoperatively in Group A and 0.315±0.047 in Group B(P<0.001). 47 patients were primary healing, neither infection nor skin flap necrosis. The formed eyelid creases were smooth with the medial portions extending proximately to the corner of the medial canthus. No lacrimal canaliculi injury occurred in any of the patients. All patients were followed up. The average follow-up time is 10.4 months. During this time no recur of epicanthal fold or scar contraction had happened.Conclusions: Z-plasty combining with orbicularis oculi muscle resection aims at ameliorating and remodifying anatomical structure of epicanthus and release the local tension. Meanwhile, the postoperative appearance improves and recurrence and scar contraction are avoided.