眶隔与眼轮匝肌分别外眦固定在睑袋修复术中的应用

The application of strengthening orbital septum and orbicularis oculimuscle by fixing them in the external canthus in plasty of bag deformity of lower eyelid

目的探讨加强眶隔、眶隔与眼轮匝肌分别外眦固定在睑袋修复术中的持久效果。方法采用经皮肤人路下睑成形术，在皮肤与眼轮匝肌、眼轮匝肌和眶隔之间分离至眼轮匝肌下缘，形成皮瓣、眼轮匝肌瓣；向下牵拉眼轮匝肌瓣，挤压眶下缘，在隆起明显处剪开眶隔，释放并去除多余的眶隔脂肪；将眶隔上下唇筋膜重叠缝合，眶隔外缘向外眦部牵拉，固定在眶外缘骨膜上，眼轮匝肌瓣向外眦处悬吊收紧固定；切除多余的皮肤，缝合切口。结果白2002年以来，共施术25例患者，术后随访3个月至5年，无并发症发生，均获满意效果。结论采用加强眶隔、眶隔与眼轮匝肌分别行外眦固定矫正睑袋，较传统的手术方法效果持久显著，应视为睑袋整复术中的一个重要步骤。

Objective To investigate the permanent effect of strengthening orbital septum and orbicularis oculimuscle by fixing them in the external canthus （eanthopexy） for plasty of bag deformity of lower eyelid. Methods The blepharoplasty of lower lid with transcutaneous incision was performed, dissection was carried between skin and orbicularis oculi muscle and orbieularis oeuli muscle and orbital septum to the inferior of the orbicularis muscle; the skin and muscle flap were pulled downwards for exposing orbital septum and infraorbital rim： tbe orbital septum was opened widely along the arcus marginalis for releasing the orbital fat; excessive orbital fat was removed; then the external edge of the orbital septum and orbieularis oeuli muscle was reset over the external orbital rim; finally the excessive skin and muscle was removed and the incision was sutured. Resuits Since 2002, a total of 25 patients had underwent this procedure. All patients were quite satisfied with the eosmetie results after 3 months to 5 years following up. Conclusion The method had permanent effect in plasty of bag deformity of lower eyelid, and it should be regarded as a significant step in lower lid blepharoplasty.