额颞部充填术的临床解剖和应用  

Fronto-temporal anatomy and its application for augmentation plasty

作　　者：何葆华[1] 谭晓燕[1] 吴卫华[1] 宋建良[1] 徐靖宏[1] 

机构地区：[1]杭州市整形医院整形外科,310014

出　　处：《中华整形外科杂志》2004年第3期206-208,共3页Chinese Journal of Plastic Surgery

摘　　要：目的　探讨额颞部充填术的安全解剖层面及现用材料的疗效比较。方法　通过 4 1例额颞部手术 ,观察比较不同解剖层面及不同材料充填后的效果。结果　额颞部充填有 4种较安全的解剖层面 :①皮下、颞浅筋膜浅面 ;②帽状腱膜下疏松结缔组织层 ,但向下不超过颧弓上 1 5cm的水平界限 ;③颞深筋膜深层与颞肌肌膜之间 ;④颞部骨膜下。术后半年至 1年以上随访患者均改善或满意 ;仅脂肪颗粒充填术后部分吸收 ,个别ePTFE片或Medpor块充填术后假体轮廓凸显、边缘阶梯样。结论　额颞部 4种安全解剖层面临床应用各有利弊 ,有时两种层面的联合应用可相互弥补不足。现有额颞部充填材料中 ,自体脂肪颗粒仍是最佳的材料。Objective To decide the safe dissection plane and evaluate the multiple materials used for the fronto-temporal augmentation. Methods Clinical anatomical observation were made during the fronto-temporal operations. Forty-one patients were treated for the fronto-temporal augmentation with various granular or patched materials in different anatomical plane. Results Four relatively safe dissection planes were found in the fronto-temporal area: ① subcutaneous or above superficial temporal fascia,②subgalea plane 1 ^5 cm above the zygomatic arch,③ between the deep temporal fascia and the temporal muscle,and ④ beneath the temporal periosteum. With the follow-ups from 6 months to 1 year,the appearance after the fronto-temporal augmentation in each patient was satisfactory or improved,except for the fat granule group with partial absorption and the ePTFE or Medpor hypothesis group shown a stepped contouring at the margin in a few patients. Conclusion Four dissection planes could be shown in the fronto -temporal region for the augmentation plasty with different advantages and disadvantages. The combination could be overcome the disadvantages to improve the results. Fat granule could be the best autograft for frontotemporal augmentation. ;

关 键 词：额颞部 充填术 临床解剖 临床解剖 临床资料 

分 类 号：R622[医药卫生—整形外科]