内镜下额颞部除皱术的改进  

Modified endoscopic rhytidectomy in forehead and temporal area

作　　者：朱金土[1] 裘华森[1] 高寿松[1] 刘波[1] 张宁 车菲[1] 徐少骏[1] 尚兴红[1] 

机构地区：[1]浙江省中医院整形美容中心,杭州310006 [2]哈尔滨市穆斯林医院整形美容科

出　　处：《中华医学美学美容杂志》2009年第5期304-307,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探讨将内镜技术应用于除皱术中以来，通过技术的改良，以获得创伤小，避免神经、血管损伤，彻底止血，固定确实的效果。方法颞部采用两个间断的小切口，避开颞浅血管的分支，在内镜辅助下于颞浅筋膜下进行剥离及止血、悬吊固定。额部在发际后做3个横行切口，在内镜辅助下操作，将额部剥离后的皮瓣向上悬吊固定于切口下方颅骨外板上。结果采用内镜额颞部除皱58例，术后肿胀程度轻，无明显瘀青，术后1周均能恢复社交活动。术后1年随访有56例（96．55％）明显改善；2年随访35例中有33例（94．29％）明显改善。未出现面神经损伤病例。结论通过内镜辅助下除皱术可充分认识到术中明视下操作，能减少术中血管、神经的误伤，便于分离、止血、缝合及悬提固定，通过技术改良能达到创伤更小，康复更快，效果更满意的目的，因此扩大了手术适应人群。Objective To explore the aesthetic efficacy of modified endoscopic rhytidectomy by using the techniques to minimize tissue damage, to obviate injury to the vessels and nerves, and to control bleeding and to firm fixation. Methods Two discontinuous incisions were made in the temporal scalp during the procedure, obviating injury to the branches of the superficial temporal vessels. En- doscopic technique was used to facilitate elevating, hemostasis, slinging and fixation in the plane under superficial temporal fascia. Three transverse incisions were made after the hairline in the forhead scalp, the operation was carried out by using endoscopic equipment, and the elevated forhead flap was slinged and fixed upward to the lamina externa cranii. Results 58 cases were received endoscopic forehead and temporal rhytidectomy, only slight edema was observed after surgery, and no obvisous ecchymosis was found. All patients returned home 7 days after operation. Degree of satisfaction on long-term follow-up showed that 56 cases （96.55 % ） improved obviously one year postoperatively; 85 cases followed up 2 years, 33 （94.29 %） of them improved obviously. None case was suffered from facial nerve injury. Conclusion The purpose of endoscopic rhytidectomy is to avoid carrying out the operation out of sight, to minimize unexpected damage to vessels and nerves, and to facilitate dissection, hemostasis, suturing, slingling and fixation. By refining the technique, we can achieve minimal injury, shorten recovery period, and obtain more satisfactory results, so the indication for operation is extended.

关 键 词：内镜 除皱术 额颞部 

分 类 号：R622[医药卫生—整形外科] R730.59[医药卫生—外科学]