内侧蒂眼轮匝肌瓣转位及眶脂肪释放修复睑袋合并严重沟槽畸形  

Transposition of orbital fat and orbicularis muscle flap over the orbital rim for correction of lowereyelid pouches complicated with lacrimal groove deformity

作　　者：谢义德[1] 詹明坤[1] 李铭[1] 江成鸿[1] 周亚宽[1] 陈小松[1] 杨育成[1] 郭志辉[1] 黄拔瑞[1] 

机构地区：[1]福建医科大学附属协和医院整形外科,福州350001

出　　处：《中华整形外科杂志》2013年第3期161-164,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨睑袋合并严重沟槽畸形矫正的方法。方法通过下睑皮肤切口，在眼轮匝肌深面分离，暴露眶隔及眶下缘骨膜，充分分离颧前间隙，打开眶膈将眶脂肪游离、释放，然后重置于沟槽畸形处眼轮匝肌深面，与眶缘下方的骨膜缝合固定，若沟槽畸形矫正不满意，将眼轮匝肌肌皮瓣向上提拉展平，并嘱患者睁眼上视，将超出切口缘部分多余的肌皮瓣，设计成内侧蒂眼轮匝肌瓣，去除表皮后转位填充于沟槽畸形相对应的位置，缝合固定。结果临床治疗72例睑袋合并严重沟槽畸形患者，通过内侧蒂眼轮匝肌瓣转位及眶脂肪重置进行矫正。随访3～6个月，所有患者术后睑袋、泪槽沟及睑颊沟畸形均得到良好纠正。结论眶脂肪重置结合内侧蒂眼轮匝肌瓣转位矫正睑袋合并严重沟槽畸形是一种行之有效的好方法。Objective To introduce the experience in the treatment of lower eyelid pouches complicated with lacrimal groove deformity by transposition of orbital fat and orbicularis muscle flap over the orbital rim. Methods An incision was made along the margin of lower eyelid and dissection was performed under the orbicularis muscle to expose the orbital septum and periosteum of lower orbital rim. The fat released from orbital septum was transposed just below the lower orbital rim and fixed on the periosteum. If lacrimal groove deformity was not corrected completely, the musculocutaneous flap, which may be excised beside the incision, was kept to correct the deformities further with only the muscle portion. Results 72 cases with lower eyelid pouches complicated with lacrimal groove deformities were treated with transposition of orbital fat and orbicularis muscular flaps. Satisfactory results were achieved in all the patients after a follow-up period of 3-6 months. Conclusion It is an effective and feasible technique to correct lacrimal groove deformities with transposition of orbital fat and orbicularis muscular flaps.

关 键 词：肌瓣 沟槽畸形 下睑袋 

分 类 号：R77[医药卫生—眼科]