眼轮匝肌下脂肪垫的解剖结构及应用

Anatomic structure and application of suborbicularis oculi fat pad

目的 :研究眼轮匝肌下脂肪垫的解剖结构 ,在临床去睑袋和下睑成形术中指导眼轮匝肌下脂肪垫的处理 ,提高美容疗效。方法 :观察 4 8具 (96侧 )尸颅的眼轮匝肌下脂肪垫的位置 ,测量其厚度 ,进行不同年龄、性别比较和同一具尸颅左右侧比较。结果 :眼轮匝肌下脂肪垫位于眶下外侧、眼轮匝肌与上颌骨和颧骨的骨膜之间 ;眼轮匝肌下脂肪垫形态不规则 ,与周围脂肪垫相连续 ,边界不清 ;眼轮匝肌下脂肪垫厚度 2 0～ 30岁及 30岁以上分别为 2 .4 9～ 2 .78和 2 .4 9～ 2 .84 m m(平均值 2 .6 6和 2 .6 8mm)。女性和男性其范围分别为 2 .4 0～ 2 .98和 2 .5 3～3.0 4 mm (平均值 2 .75和 2 .79mm)。左右侧其范围分别为 2 .5 3～ 2 .6 5和 2 .5 1～ 2 .6 9m m (平均值 2 .5 9和2 .6 1mm)。可见在不同年龄、性别和侧别眼轮匝肌下脂肪垫厚度差异无显著性 (P>0 .0 5 )。消瘦型、适中型和肥胖型其范围分别为 2 .4 0～ 2 .6 5、 2 .73～ 2 .89和 2 .96～ 3.0 4 m m (平均值 2 .5 4、 2 .81和 2 .99mm )。可见不同体形间眼轮匝肌下脂肪垫厚度差异有显著性 (P<0 .0 5 )。结论 :在睑袋整形术中 ,应同时切除眼轮匝肌下脂肪垫 ,或将错位的脂肪垫复位 ,可大大提高去睑袋美容疗效。

Objective To study the anatomic structure of suborbicularis oculi fat pad(SOFP)to guide the management of SOFP in the operation of removing the eyelid pouch and the plastic operation of lower eyelid in order to improve the curative effect of cosmesis. Methods The locations of SOFP in 48 corpse skulls (96 sides) were observed. The thickness of SOFP was measured. The comparisons of SOFP in different ages, sex, and somatotypes, between left side and right side in one corpse were made. Results The SOFP located the outside of orbit;among of suborbicularis oculi, top jaw bone and zygomatic bone′s periosteum. The fat pad′s appearance was irregular, connecting with each other, and with surroundings fat mat continuously, and the boundary was not clear. The SOFP′s thicknesses were 2.49-2.78 and 2.49-2.84 mm, respectively, in 20-30 and >30 years old (mean values were 2.66 and 2.68 mm, respectively). The SOFP′s thicknesses of males and females were 2.40-2.98 and 2.53-3.04 mm respectively (mean values were 2.75 and 2.79 mm, respectively). The SOFP′s thicknesses of left side and right side were 2.53-2.65 and 2.51-2.69 mm(mean values were 2.59 and 2.61 mm, respectively ). Therefore no significant differences of the SOFP′s thickness were found in different sex, ages or sides(P>0.05). The SOFP′s thicknesses of emaciated, moderate, and obese somatotypes were 2.40-2.65,2.73-2.89, and 2.96-3.04 mm(mean values were 2.54, 2.81, and 2.99 mm, respectively).So there were significant differences of SOFP′s thickness among different somatotypes (P<0.05). Conclusion In the plastic operation of eyelid pouch, the SOFP should be cut off at the same time, or reply the mistaken fat pad to improve the curative effect.