眼轮匝肌悬吊法眶周除皱术  

A new technique of periorbital rhytidectomy with musculus dormitator suspension

作　　者：蹇洪[1] 黎瑞红[1] 何明武[1] 陈红梅[1] 易传勋[2] 

机构地区：[1]湖北省十堰市太和医院整形美容中心,十堰442000 [2]华中科技大学同济医学院

出　　处：《中华医学美学美容杂志》2008年第3期152-155,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探索一种操作简单、安全、有效的眶周除皱术式。方法在肿胀麻醉下，通过眉区切口入路，在眼轮匝肌眶部外侧深面向下剥离1cm，将眼轮匝肌上提固定于颞深筋膜或额骨骨膜上；于内侧显露降眉肌和皱眉肌并离断之。然后，通过皮肤入路睑袋成形术切口，在行睑袋成形术的同时，在眼轮匝肌与其下脂肪组织间分离眼轮匝肌眶部外侧，形成眼轮匝肌肌皮瓣，向外上方提紧，固定于眶骨骨膜上。对于颧颊部丰满、鼻唇沟明显者，可同时悬吊固定颧脂肪垫。结果65例中年女性，术后随访3～16个月，切口瘢痕不明显，静态时鱼尾纹、眉间纹消失，上睑松弛及眉下垂完全矫正，鼻唇沟纹明显减轻，95％的受术者对手术效果满意。并发球结膜水肿者4例，经热敷治疗，1个月内均消退，无面神经损伤及其他并发症发生。结论眼轮匝肌悬吊法采用新的切口入路，完全避开面神经，手术操作简单，安全，切口隐蔽，疗效可靠持久，创伤小，恢复迅速，是一种较好的眶周除皱手术方法。Objective To study one simple, safe and effective method of periorbital rhytidectomy. Methods With turgescent anesthesia, 1 cm -extent was dissected laterally deep under musculus orbicularis oculi at the approach of eyebrow area. The musculus orbicularis oculi was fixed to the deep temporal fascia and frontal periosteum. The superciliary corrugator muscle and depressor muscle were exposured and cut. Then the eyelid blepharoalasty was performed through the skin incision, meanwhile the lateral pars orbitalis muscle was liberated to form an orbitalis muscle flap under the orbitalis muscle and the fat pad, which was fixed to the os orbitale periost by lifting tight to lateral and upper side. For patients with generous pars buccalis and obvious nose lip ditch, the cheekbone fat cushion was also hanged and fixed. Results 65 middle age female patients were followed up for 3 - 16 months. The scar was no obvious, glabellar wrinkle and canthal wrinkle disappeared at static state, relaxed upper eyelid and eyebrow prolapse reached to complete correct, nasolabial groove wrinkle obvious lessened. 95 % patients were satisfacted with the appearance. Conjunctival edema was found in 4 cases, and disappeared within 1 months. There were no facial nerve injury and other complications. Conclusions It isa new incisional approach that avoids the facial nerves and lessens fossa orbitalis retrogradation. The operative procedure is simple and safe, and its incision is occult. The wound is small and restores rapidly, but the effect is reliable and lasting. It proves to be an ideal approach for face rejuvenation.

关 键 词：眼轮匝肌 悬吊 除皱术 

分 类 号：R622[医药卫生—整形外科]