轴型筋膜瓣加植皮修复下睑外翻及眶下组织重度凹陷

AXIAL APONEUROTIC FLAP COMBINED WITH SKIN GRAFT IN THE TREATMENT OF LOWER LID ECTROPION AND SEVERE INFRA ORBITAL SOFT TISSUE DEPRESSION

目的探讨各种原因引起的下睑外翻及眶下组织重度凹陷的修复方法。方法经过对颞区解剖分析，采用带颞浅动脉顶支的帽状腱膜、颞膜轴型瓣加游离植皮的方法，修复眶下组织重度凹陷及下睑外翻６例。结果带颞浅动脉顶支的颞筋膜与帽状腱膜联合移植由于具有丰富的血供，可转移到１５～１８ｃｍ远的部位，在此筋膜上植皮可获得良好成活。临床应用６例均得到矫正，下睑凹陷消失。术后随访１年，外观良好，效果满意。结论此方法具有组织瓣血供好，对供区破坏小，充填效果好，外观良好。

Objective The correction of ectropion of lower lid and severe infra orbital soft tissue depression is very difficult. Former methods included simple skin graft, tubed graft, transfer of local skin flap and so on. These methods had some disadvantages, such as not enough tissue to fill the depression, too much damage done to the donor area and operation in stages required. Methods After investigation on the anatomy of temporal region, designed the following method. Combined transfer of the galea aponeurotica and temporal fascia was used to repair severe infra orbital soft tissue depression and ectropion of lower lid in 6 cases. Results It was discovered that the combined transfer of the galea aponeurotica and temporal fascia was rich in blood circulation because they received blood supply from parietal branch of superficial temporal artery and could be transfered to a distance as far as 15～ 18 cm. The skin graft used to cover the fascia usually resulted in good survival. This technique was used in 6 cases with good success. Conclusion This method had some merits such as the tissue flap had good blood supply, little damage done to the donor area, good correction of the severe depression, good appearance following correction, operation done under local anesthesia and completed in one stage operation.