外切口骨膜上下双层面剥离在泪沟型睑袋整复术中的应用  

Application of External Incision Periosteal Double-layer Dissection in Lacrimal Groove Blepharoplasty

作　　者：许素琪 李高峰[1] 张杨 丁卫[1] 张博[1] XU Su-qi;LI Gao-feng;ZHANG Yang;DING Wei;ZHANG Bo(Department of Plastic and Cosmetic Surgery,Hunan Provincial People’s Hospital,the First Affiliated Hospital of Hunan Normal University,Changsha 410005,Hunan,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)整形激光美容外科,湖南长沙410005

出　　处：《中国美容医学》2021年第4期5-7,共3页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨外切口骨膜上下双层平面剥离形成腔隙,用眶脂肪填充矫治泪沟型睑袋的效果。方法:2016年1月-2018年1月治疗伴有下睑皮肤松弛的泪沟型睑袋患者63例,126眼,其中Ⅱ型泪沟85眼,Ⅲ型泪沟41眼。经皮肤入路,在眼轮匝肌深面分离至眶骨弓状缘,切开弓状缘内侧骨膜,在骨膜下剥离至中外侧时,透过骨膜,转至骨膜上剥离,形成骨膜下和骨膜上双层面腔隙。将眶脂肪下拉,内侧置于骨质上平面,外侧置于骨膜上平面。结果:术后6个月评价:Ⅲ型泪沟中6眼转变为Ⅰ型,所有Ⅱ型及其余Ⅲ型泪沟均消失,所有患者的睑袋及下睑皮肤松弛得到明显改善,未出现后期睑外翻、下睑凹陷等并发症。56例满意(满意率为88.9%),7例基本满意,无不满意者。结论:外切口骨膜上下双层平面剥离形成腔隙,用眶脂肪填充对于下睑皮肤明显松弛的泪沟型睑袋患者有良好的改善效果。Objective To investigate the application effect of orbital fat filling by external incision periosteal double-layer plane peeling in lacrimal groove blepharoplasty.Methods 63 patients,126 eyes,which have baggy and tear trough deformity with obvious skin laxity received the lower blepharoplasty from January 2016 to January 2018.85 and 41 eyes were of Hirmand typeⅡandⅢrespectively.Blunt dissection was performed under the orbicularis oculi muscle to expose the periosteum of the arcus marginalis through the transcutaneous approach,and the periosteum was incised medially.The periosteum was dissected medially in the subperiosteal plane to the medial,and then in the supraperiosteal plane laterally.The orbital septum fat was tiled down and fixed in the sub-and supra-periosteal planes on the medial and lateral sides respectively.Results Postoperative evaluation at 6 months:6 eyes of Hirmand typeⅢreverted to typeⅠ.In the rest cases,the lower eyelid pouch and tear trough depression disappeared and the dermatochalasis improved significantly.No complications such as ectropion or hollowing of the lower eyelid were observed.56 patients(88.9%)were satisfied,7 patients were partially satisfied,and no one was dissatisfied.Conclusion Double-layered dissection of periosteum and orbital septum fat redistribution through transcutaneous approach is suitable for patients with baggy and tear trough deformities,and obvious dermatochalasis in the lower eyelid.

关 键 词：睑袋 泪沟 下睑皮肤松弛 睑袋整复术 双层面剥离 

分 类 号：R622[医药卫生—整形外科]