眶隔及眼轮匝肌双重紧缩的睑袋整复术

Orbitaiseptum and orbicularismuscle two-layer tightening of blepharoplasty

目的:为提高睑袋整复术的效果,从理论与实际的角度探讨睑袋的形成原因及病理改变,采用眶隔及眼轮匝肌双重紧缩的方法进行睑袋整复术。方法:在局麻下,作下睑缘1～2mm的切口,皮下潜行剥离至骨性眶缘形成皮瓣,在眶隔膜表面分离形成与皮瓣形态一致的下睑眼轮匝肌瓣。打开眶隔,尽量还纳疝出的眶隔脂肪,如疝出的眶隔脂肪量较多,可部分切除。横向折叠缝合眶隔2～3针,向外上方提紧眼轮匝肌瓣,楔形切除适量的眼轮匝肌,断端固定在眶缘的骨膜上。最后,切除下睑多余的皮肤。结果:本组共40例,随访20例3个月～2年,除1例因眼轮匝肌切除过多而产生轻度下睑退缩外,其余均效果满意持久。结论:眶隔及眼轮匝肌双重紧缩的睑袋整复术,是针对下睑衰老机理及表现而进行的一种手术设计,可提高手术效果并延长术后有效时间。

Objective To investigate the formation cause and pathological change of pouches through orbital septum and orbicularis muscle two -layer Tightening and to improve the effection of blepharoplasty. Methods After local anesthesia,curve incision 1-2mm below to eyelash, Reseparating in subcutaneous layer to pro-jection point of infraorbital margin skin flap was formed muscle flaps were formed on orbital septum with sharp and blunt dissection. orbitaiseptum was opened, orbital fat was reposited to orbital septum.lf there was excessive fat, It had to be cut off. Orbital septum was folded and sutured in transverse direction.Wedge-shaped excision of orbicular muscle flap was tightened and fixed to supe-rior-lateraldirection.redundant skin flap were excised. Results Of the 40 patients with this operation, 20 cases were carried out follow-upvisits from 3 months to 2 years.The short-term and long-term results were satisfactory for 19 cases.One case showed mildre-Traction of lower lid. Conclusion This technique of orbitaiseptum and orbicularismuscle two-layer Tightening eyelid baggy can achieve both short-term and long-term satisfactory results.