Frontalis Suspension

It is suitable for patients with poor upper levator muscle function (muscle strength of upper levator levator is less than 4mm) and complete frontal muscle function. Treating diseases: eye diseases Indication It is suitable for patients with poor upper levator muscle function (muscle strength of upper levator levator is less than 4mm) and complete frontal muscle function. Preoperative preparation For the determination of the frontal muscle strength, the patient looks in front of the eye, and marks the center of the pupil at the lower edge of the eyebrow. The ruler is fixed vertically at the mark, and the patient lifts the eyebrow and the number of millimeters moved on the scale represents The momentum of the frontal muscles. The mobility of the adult frontal muscles is about 10 to 15 mm. Surgical procedure Fascia fascia suspension Under local anesthesia, the fascia is cut before the lower third of the thigh. The size is determined according to the need, generally 8mm wide and 40mm long. Open the incision with a wide fascia wound or intermittent suture, or enlarge the incision up and down to avoid postoperative tendon. The sutured skin incision was closed and the pressure was bandaged. 1. Make a 5mm long incision parallel to the gingival margin at the junction of the middle 1/3 junction and the outer 1/3 of the upper skin fold, separating the orbicularis muscle depth and the tarsal plate. At the junction of the middle 1/3 and the outer middle 1/3 of the upper edge of the brow arch, a corresponding horizontal incision is also made, which is 5 mm wide, deep and periosteum. 2. Use a mosquito-type vascular forceps to separate the eyelids from the eyelids into the corresponding incisions of the eyebrows and sneak them under the orbicularis muscles to form a tunnel. The fascia lata was folded into 4mm×40mm, and the fascia strip was introduced into the tunnel with the fascia needle. The end of the fascia was fixed and sutured to the sac before the sacral incision. 3. Then, the fascia strip is pulled upward at the incision of the eyebrow and the height of the splitting is increased. Generally, the upper margin is located at the upper edge of the cornea. Fix the fascia strip to the periosteum. For a single-eye patient, it is advisable to lift the upper iliac crest to 1 to 2 mm higher than the healthy eye. Suture suspension 1. Shun the crease, cut the skin and the orbicularis muscle, deep into the tarsal plate. The upper third of the upper edge of the eyebrow, the central part, and the outer middle 1/3 each make a transverse skin incision with a length of about 5 mm, reaching the periosteum. Between the inner 1/3 of the upper incision, the central part, the outer mouth 1/3 and the corresponding eyebrow arch incision, a mosquito-type vascular clamp is used to make a tunnel between the orbicularis oculi muscle and the iliac crest. 2. Use the 0 white wire as the two square coils. First pass through the center of the seesaw according to the figure, and then pass through the tunnel with the semi-straight needle through the tunnel. The two silk threads in the central part of the eyebrow arch are marked with different loops, and are passed through the periosteum to the eyebrows of both sides to form two square coils. Evenly tighten the eyebrow arch wire, adjust the height and curvature of the split, and tighten the wire to the sides. First hit a slip knot and observe whether the arc of the upper edge is ideal and symmetrical. Then ligature separately. The eyelid skin incision is used as a suture plate fixation suture, and the eyebrow arch incision is used for intermittent suture.