眼轮匝肌“窗口法”在切开法重睑成形术中的应用  

The clinical application of oribicularis oculi fenestration in blepharoplasty

作　　者：王永洁[1] 李梦娟 龙剑虹[1] WANG Yongjie;LI Mengjuan;LONG Jianhong(Department of Burn and Plastic Surgery,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院烧伤整形科,湖南长沙410008

出　　处：《中国美容整形外科杂志》2024年第9期519-521,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的观察上睑提肌腱膜瓣或睑板前筋膜瓣穿过眼轮匝肌窗口前徙固定的仿生法重睑成形术的临床效果。方法自2018年7月至2020年1月,中南大学湘雅医院烧伤整形科对286例单睑患者采用眼轮匝肌“窗口法”行切开法重睑成形术。术中显露切口之间眼轮匝肌,分别于内侧、中间、外侧去除约2 mm×2 mm的眼轮匝肌组织形成窗口,窗口内为上睑提肌腱膜组织或睑板前筋膜组织,形成上睑提肌腱膜瓣或睑板前筋膜瓣,分别将3处窗口部位的下唇皮肤、下唇眼轮匝肌、窗口内上睑提肌腱膜瓣或睑板前筋膜瓣与上唇皮肤做缝合固定,其余位置皮缘直接缝合。结果286例患者均于术后7 d拆线。所有患者术后随访12~24个月,重睑线形态自然流畅,闭眼时切口隐蔽,无凹陷性、“台阶样”瘢痕。满意度评价:280例满意,6例不满意,其中双侧重睑不对称3例,重睑线变浅3例,满意率为97.9%。结论眼轮匝肌“窗口法”切开重睑成形术是一种可靠稳定、瘢痕隐蔽、重睑效果自然流畅、接近仿生的重睑成形术,值得推广应用。Objective To explore a surgical method for the naturally dynamic double eyelid by advance and fix the levator aponeurosis flap or pretarsal fascia flap through the windowof oribicularis oculi.Methods From July 2018 to January 2020,oribicularis oculi fenestration blepharoplasty were performed on 286 patients.Orbicularis oculi muscle in incisional area were completely exposed,then three 2 mm×2 mm orbicularis oculi muscle(at medial,middle and lateral)were romoved to form windows.The levator aponeurosisor pretarsal fascia exposed in the windows,forming the levator aponeurosis flap or pretarsal fascia flap,then sutured from lower skin,lower orbicularis oculi muscle,levator aponeurosis flap or pretarsal fascia flap to upper skin in windows respectively,the other parts were sutrued lower skin with upper skin.Results All 286 patients were took out the sutures after 7 days.With up to 12 to 24 months follow-up,the new double eyelid presented smooth appearance,no obvious concave groove or step-like deformity when eyes closed.Satisfaction evaluation:280 patients were satisfied with the outcomes,6 patients were not satisfied.Three patients complained about asymmetry.Three patients had shallower supratarsal folds.The patients'satisfaction rate was 97.9%.Conclusion Oribicularis oculi fenestration blepharoplasty is a stable,lasting,scarless approach for natural and dynamic double-eyelid blepharoplasty.

关 键 词：切开法重睑成形术 眼轮匝肌 窗口法 

分 类 号：R779.6[医药卫生—眼科] R62[医药卫生—临床医学]