劈裂式ROOF切除技术治疗上睑臃肿  

Split retro-orbicularis oculi fat resection for correction of bulky upper eyelid in Asian blepharoplasty

作　　者：李华[1] LI Hua(Department of Plastic and Reconstructive Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院整复外科,上海市200011

出　　处：《组织工程与重建外科》2023年第3期270-274,共5页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：上海市科委项目(上海市整形与修复重建临床医学研究中心,22MC1940300)。

摘　　要：目的探讨使用劈裂式分层去除眼轮匝肌下脂肪(Retro-orbicularis oculi fat,ROOF)治疗上睑臃肿的效果及可行性。方法2018年至2022年,上睑臃肿患者行重睑术共456例,均采用劈裂式ROOF去除方法。术中将ROOF充分游离后,从游离缘将脂肪往眉部劈开,完整保留眶隔前壁的同时,最大程度去除ROOF,同时适量去除眶隔脂肪及部分眼轮匝肌。分层缝合眼睑,使眼轮匝肌的张力不直接作用在眼睑皮肤上。456例中有158例患者合并有不同程度的上睑下垂,在术中予以上睑提肌缩短矫正。结果所有患者术后随访3~48个月(平均26.3月),454例形成了稳定的重睑皱褶,2例分别在术后15个月及术后18个月时重睑皱褶变浅消失,予以修复。所有患者臃肿的上睑外观都得到明显改善,20例患者手术切口位置有色素脱失,无凹陷性瘢痕、三眼皮等并发症发生。结论劈裂式ROOF去除结合眼睑分层缝合技术,能有效改善上睑臃肿,同时形成稳固的重睑,并能防止术后凹陷性瘢痕和三眼皮等并发症的发生。Objective To explore the feasibility and effectiveness of the split retro-orbicularis oculi fat(ROOF)resection technique for the correction of bulky upper eyelid in double-eyelid surgery.Methods From 2018 to 2022,a total of 456 cases of double eyelid surgery with bulky upper eyelid were treated with the split ROOF resection technique.After fully dissection of ROOF pad,the fat was split from the anterior orbital septum,so as to completely preserve the anterior orbital septum while removing ROOF to the maximum extent.Meanwhile,appropriate amount of orbital septum fat and part of orbicularis oculi muscle were removed.The eyelid was sutured in layers so that the tension of the orbicularis oculi muscle does not directly act on the eyelid skin.There were 158 patients in 456 cases with different degrees of ptosis.They were corrected by levator palpebrae superioris shortening during the double eyelid blepharoplasty.Results The 456 patients were followed up for 3-48 months,with an average of 26.3 months.Among the 456 patients,454 cases formed stable double eyelid fold,and two cases became shallow and disappeared 15 months and 18 months after surgery,respectively.The appearance of bulky eyelid was significantly improved in all patients,20 patients had depigmentation at the surgical incision site,and no sunken scar,triple eyelid and other complications occurred.Conclusion Split ROOF removal combined with eyelid layering suture technique can effectively improve bulky upper eyelid,form a stable appearance of double eyelid,and prevent postoperative complications such as sunken scar and triple eyelid.

关 键 词：眼轮匝肌下脂肪 重睑术 上睑臃肿 

分 类 号：R[医药卫生]