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要約 目的:眉の上を押さえ,前頭筋が働かない状態でも開瞼可能な眼瞼下垂症と,外観,術中の眼窩隔膜の状態との間に関係があるかを検討した。
対象と方法:2009年11月〜2018年7月の間に腱膜性眼瞼下垂に対して腱膜固定術を施行した一連の113人211眼を対象とした。対象を外観より強い奥目,奥目,普通,腫れぼったいの4群に分け,眉の上を押さえたときの開瞼状態,術中の眼窩隔膜の状態との関係を診療録から後ろ向きに検討した。
結果:眉の上を押さえたときの開瞼状態は,強い奥目,奥目,普通,腫れぼったいの各群でそれぞれ,開瞼可は60%,34.4%,10.6%,4.9%,開瞼不可は13.3%,45.9%,76.6%,87.8%で,奥目ほど開瞼可が多く,腫れぼったいほど開瞼不可が多かった。眼窩隔膜と外観との関係は,隔膜が薄い症例はそれぞれ69.2%,53.3%,20.8%,0%で,奥目ほど薄い傾向があった。
結論:眉の上を押さえたときに開瞼できる症例は,奥目の傾向が強いほど多かった。眼窩隔膜は奥目の症例ほど薄く,強い奥目では前頭筋の作用が瞼板に伝わりがたいと考えられた。
Abstract Purpose:We examined the relationship between the blepharoptosis that opens the eyelids when applying pressure on the eyebrows frontalis muscle that is not working, the eyelid appearance, and the condition of the orbital septum during the operation.
Subject and method:We examined 113 patients(211 eyelids)that underwent aponeurotic fixation operations who suffered from blepharoptosis between November 2009 and July 2018. We classified 4 groups from the eyelid appearance:severe concave-shaped eye, mild concave-shaped eye, normal and swelling eye. We analyzed the relationship between the four type of eyelid appearance, the condition of the eyelid when applying pressure on the eyebrow, and the condition of the orbital septum during the operation retrospectively.
Result:The appearance of the eye in the 4 groups that the eyelids could open was 60%, 34.4%, 10.6%, 4.9%, the eyelids that couldn't open was 13.3%, 45.9%, 76.6%, 87.8%, and there was a significant difference. The percentage of the thin orbital septum, was 69.2%, 53.3%, 20.8%, 0%, respectively. The thinner orbital septum, has a higher tendency of concave-shaped eye.
Conclusion:We found that the eyelids that can open when we applying the pressure on the eyebrow have a greater tendency of concave-shaped eyes. Concaved-shaped eyes have a thinner orbital septum, so the action of venter frontalis does not fully transmit to the tarsus.
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