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内镜在额颞部除皱术及术后再次修复中的应用

Endoscopic assistance in a variety of complicated facelift and postoperative repair in frontal and temporal areas

摘要目的 探讨内镜在额颞部除皱术及术后再次修复中的应用及临床效果.方法 对67例受术者内镜下行额颞部除皱术,其中22例为额颞部除皱术后再次内镜下修复者.随访时间1个月至2年,受术者和医师对术后满意率作为评价标准,同时记录各种术后并发症.结果 67例受术者术后完全康复,无严重并发症发生.受术者的满意率为85%(57/67),医师的满意率为89%(60/67).80%左右受术者术后早期出现轻微并发症,如挂线处小坑、轻度不对称、过度矫正、短期皮肤麻木、术后肿胀、较明显瘢痕和脱发等.4例受术者术后在额部皮下出现皮下淤青和较小血肿,早期穿刺抽吸后加压包扎,后期经过局部热敷,术后2周左右血肿逐渐吸收,恢复正常.2例受术者术后3个月左右颞部切口出现反复红肿,头皮表皮出现破溃后自愈,半年后经原切口取出钛钉和周围悬挂缝线,切除切口边缘瘢痕组织后缝合,切口Ⅰ期愈合.2例由于术中电凝误伤,出现额部小范围皮肤坏死,局部换药,愈合后出现小坑样凹陷性瘢痕,半年后逐渐变平,小坑不明显.所有上述并发症经过处理后均愈合良好.结论 内镜在额颞部除皱及术后再次修复中很有价值,尤其对于50岁以内的受术者应用内镜额颞部除皱及术后再次修复效果良好.

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abstractsObjective To introduce the advantages of the endoscopic assistance in primary and secondary face-lift in the frontal and temporal areas.Methods 67 cases were involved in the study,22 of them were secondary facelift cases.The follow-up period ranged from 1 month to 2 years.The patients and doctors satisfactory rate were recorded and the complications were also reported.Results All 67 cases had complete recovery without serious complications.The patient's satisfactory rate was 85% (57/67),and the doctor's satisfactory rate was 89% (60/67).Some early minor complications included dimpling at the suture site,asymmetry,overcorrection,transitory paralysis,late edema,scar and fall-off of hair among 80% or so of patients.4 cases experienced hematoma on the frontal areas.The hematoma disappeared after early aspiration and later fomentation.2 cases had wound ulceration in the temporal 3 months after operation.The anchoring materials were removed and the ulceration tissues were excised 6 months after operation.The wound healed completely.2 patients experienced skin necrosis and depression due to careless electric cauterization on the frontal area.The depression gradually became smooth and inconspicuous after 6 months.All these complications were resolved and became negligible about 6 months after operation.Conclusions Endoscopic assistance is valuable in primary and secondary face-lift in the frontal and temporal areas.It is reliable and worthwhile to introduce the technique for patients aged less than 50-year-old.

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DOI 10.3760/cma.j.issn.1671-0290.2014.01.001
发布时间 2014-03-21(万方平台首次上网日期,不代表论文的发表时间)
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