摘要
目的 为提高鱼尾纹的除皱效果 ,延长有效时间 ,从理论与实际观察探讨鱼尾纹的形成原因及形态改变 ,采用相应的手术术式矫正。利用膨体聚四氟乙烯 (ePTFE)软组织补片衬垫于眼轮匝肌表面的方法 ,尝试矫治鱼尾纹。方法 在局麻下 ,沿颞部发际内切口入路 ,仔细将皮肤与外侧眶部眼轮匝肌分离开 ,随后将 1mm厚ePTFE软组织补片仔细舒平覆盖于眼轮匝肌表面及部分颞浅筋膜表面 ,并缝合固定。最后 ,将皮瓣上提并将皮下组织与颞深筋膜固定 ,去除多余皮肤缝合切口。结果 本组共 2 8例 ,均为女性 ,年龄 2 8～ 5 4岁 ;1例由于补片皱褶 ,术后第 3d重新手术 ,将补片展平 ;获随访 17例 1～ 8个月 ,鱼尾纹在面部静态下完全消失 ,眼周表情时鱼尾纹基本消失 ,局部外观自然 ,手术效果良好而持久 ,令医患双方满意。结论 ePTFE软组织补片衬垫矫治鱼尾纹 ,解除眼轮匝肌对皮肤的动力作用 ,是针对鱼尾纹形成机理及表现而进行的一种术式设计 。
Objective To observe and probe the causes and shape changes of crowsfeet lines, and try to apply expanded Polytetrafluoroethylene (ePTFE) soft tissue patch onto the surface of orbicularis oculi muscle for a longterm satisfactory effect of rejuvenation of crowsfeet lines.Methods After local anesthesia, a curve incision internus of temporal hair line was made .Clissection between skin and lateral orbicularis oculi muscle of orbital part was conducted carefully. Orbicularis oculi muscle and parts of temporal superfacial fascia were overlain by 1mm thick ePTFE soft tissue patch, and the patch was fixed with suture. Finally, skin flap was lifted and fixed to temporal deep fascia, redundant skin was excised and sutured. Results 28 female cases aged 28～54 were managed with this operation . As the patch of 1 case being folded, the operation was performed again on the third day of postoperation. For 17 cases followup from 1 month to 8 months was carried out. In the follow up it was found that Crowsfeet lines disappaered essentially or completely. The effect of the Crowsfeet lines correction was satisfactory.Conclusion This result strongly supports the safety and efficacy of ePTFE to be patched in the correction of crowfeet lines both in a short term and a long run.
