| Objective:Comparative analysis of combined fascial sheath suspension(CFSS)and modified frontal aponeurosis(FMS)to correct preoperative and postoperative conditions of severe congenital ptosis in children,and to evaluate CFSS correction for severe congenital ptosis in children Feasibility.METHODS: A retrospective study was conducted in 49 children from the Department of Ophthalmology,Hunan Children's Hospital from October 2016 to October 2017,who met the inclusion criteria for severe congenital ptosis in general anesthesia with fascia sheath suspension.52 eyes(3 cases on both sides,21 cases on the right side,25 cases on the left side),and collected a total of 53 eyes of 48 children with severe congenital ptosis with standard descending modified frontal aponeurosis.5 cases on both sides,25 cases on the right side and 18 cases on the left side).Observed and recorded the curative effect of the two groups and the cleft palate closure,upper jaw mobility,MRD1,tear film rupture time,postoperative complications,postoperative complications,postoperative day 2,1 month,3 month,6 month,and 1 year postoperatively.Satisfaction,using the test and test for statistical analysis of the two sets of data.RESULTS: The preoperative rupture height,frontal muscle strength,levator muscle strength,MRD1,tear film rupture time,and age respectively.The difference was not statistically significant.The comparison of the therapeutic effects of the two surgical treatments the difference was not statistically significant.The values of postoperative upper iliac activity range at 2 days,1 month,3 months,6 months,and 1 year,respectively,and the difference was statistically significant.The values of cleft palate insufficiency in the two groups respectively,after 2 days,1 month,3 months,6 months,and 1 year.The difference was statistically significant.The values t of postoperative MRD1 at 2 days,1 month,3 months,6 months,and 1 year were respectively.There was no significant difference between the 2 days after surgery and the 1 month after surgery.However,the difference of P <0.05 at 3 months,6 months,and 1 year after surgery was statistically significant.Postoperative early complications statistics showed that there were 3 eyes in the CFSS exposed keratitis,1 in the trichiasis,2 in the conjunctival prolapse,and 3 in the eyeball.The early complications of FMS were exposed keratitis.5 eyes,2 eyes with trichiasis,3 eyes with conjunctival prolapse,1 eye with orbital hematoma,2 eyes with obvious edema.The early postoperative complications of the two surgical methods were 0.826,P >0.05.One patient had postoperative recurrence of CFSS after operation,and two eyes recurred after FMS.The postoperative complications were 0.826,and the difference was not statistically significant.The postoperative satisfaction survey had a comparison value of 0.252,and the difference of P >0.05 was not statistically significant.The postoperative BUT values t were 1.09,2.507,and 2.245 at 2 days,1 month,and 3 months after surgery.There was no significant difference between the two days after surgery P > 0.05.The difference between1 month,and 3 months P<0.05.Conclusion: CFSS and FMS have a good corrective effect on children with severe congenital ptosis.CFSS is more in line with the physiological anatomy of the upper jaw,and has the advantages of light postoperative reaction,postoperative cleft palate closure time,upper jaw mobility,tear film rupture time recovery and good repeatability.However,some children have poor development of CFS structure,and it is impossible to judge the condition of the superior rectus muscle after general anesthesia.The upper limit of postoperative rotation may occur.The surgeon is required to fully understand the anatomy of the CFS structure and have good surgical operation experience.CFSS is an optional surgical procedure for correcting children with severe congenital ptosis. |
PDF Full Text Request