颧脂肪垫的解剖结构在整形外科的临床意义

Clinical significance of malar fat pad in the anatomy of plastic surgery

目的探讨颧脂肪垫的解剖结构在整形外科的临床意义。方法取已防腐处理及动脉灌注乳胶的尸体整头颅标本12个(共24个侧面)进行颧脂肪垫的位置、血液情况以及毗邻关系等解剖结构的研究。选择2009年4月～2010年10月期间来我院进行颧脂肪垫提紧复位手术的患者59例,对其手术感染情况及满意度进行随访。结果颧脂肪垫位于面中部皮下脂肪层的上界,下睑眼轮匝肌眶部前方,其内界可到达鼻唇沟、上唇及口角,下界可到达下颌缘,外界达耳屏前,除下睑眼轮匝肌睑部外,其余部位均有皮下脂肪层存在。颧脂肪垫的血液供应丰富。颧脂肪垫与皮肤、皮下脂肪层之间存在3个结合区域,关系较为密切。有5.08%(3/59)的患者手术后发生感染,术后即时满意率为100%(59/59);随访1年后满意率为93.22%(55/59);随访2年及以上者满意率89.83%(53/59)。结论在中老年患者面部老化松垂的美容手术中,对颧脂肪垫进行有效的处理,可以使手术达到较为理想的效果,使得该结构在外科整形手术中具有十分重要的意义。

【Objective】 To probe into the clinical significance of malar fat pad in the anatomy of plastic surgery.【Methods】 12 entire arterial latex skull specimens（a total of 24 sides of the malar fat pad,as well as the blood near the anatomical structures were taken to study.Select April 59 cases of reduction surgery patients from April 2009 to October 2010 admitted to our hospital for the malar fat pad tight,their satisfaction with surgical infection and were followed up.【Results】 Midface malar fat pad was located in the subcutaneous fat layer of the upper bound,lower eyelid orbicularis muscle in front of the orbit,the nasolabial fold can be reached within the upper bound,upper lip and mouth,the lower bound can be reached marginal mandibular,outside of the tragus,lowered eyelid orbicularis muscle,the remaining parts of the subcutaneous fat layer were present.Malar fat pad has the rich blood supply.Malar fat pad had closer relationship with the skin and subcutaneous fat layer.5.08% of patients after surgery（3/59） infection,immediate postoperative satisfaction rate was 100%（59/59）;after 1 year satisfaction rate of 93.22%（55/59）;followed up for 2 years or more were satisfied rate of 89.83%（53/59）.【Conclusions】 Aging in elderly patients with agging facial cosmetic surgery,on the malar fat pad for effective treatment,surgery can achieve more desirable results,making the structure of plastic surgery has great significance.