剥离弓状缘眼轮匝肌在伴有泪槽和睑颊沟的眼袋整复中的应用

The application of undermining orbicularis oculi muscle from orbital rim for the correction of tear trough deformity and palabromalar groove in lower blepharoplasty

目的探讨伴有明显泪槽和睑颊沟的眼袋整形手术方法。方法2007年1月至2011年6月，对56例眼袋伴泪槽和睑颊沟畸形者，在术中充分剥离松解弓状缘眼轮匝肌，尤其是附着在内侧泪槽处眶下缘骨膜面的眼轮匝肌，将眶隔脂肪释放重置并缝合固定于眶下缘下方4．6mm处骨膜面上，进行泪槽和睑颊沟充填。结果术后随访3—18个月，54例眼袋消失，无下睑凹陷、不平整等；1例术后1个月出现下睑皮下局部凹凸不平，3个月后经结膜人路修复后改善；1例出现下睑缘轻度退缩，经局部理疗后睑缘退缩消失。结论剥离松解弓状缘眼轮匝肌，行眶隔重置，对矫正伴有泪槽及睑颊沟畸形的眼袋效果良好。

Objective To evaluate the role of undermining orbicularis oculi muscle from Orbital rim for the correction of tear trough deformity and palabromalar groove in lower blepharoplasty. Methods 56 cases of lower eye baggy deformity with tear trough deformity and palabromalar groove were treated with the procedure of stripping eye orbieularis oeuli muscle from orbital rim by a transcutaneous approach in lower blepharoplasty. The orbital septum was opened along the arcus marginalis for releasing the orbital fat.Some orbital fat was removed if necessary. Then the inferior edge of the orbital septurn fat was reset over the orbital rim so as to smooth the infraorbital groove. Results 56 patients were available for 6 to 18 month＇ s follow-up. 54 patients were quite satisfied with the cosmetic result. One developed lower eyelid retraction and another one showed asymmetrical subcutaneous local uneven after I month＇ s. They were all corrected by the second operation after 3 months. Conclusions Stripping orbicularis oculi muscle from orbital rim plays an important role for the correction of tear trough deformity and palabromalar groove in lower blepharoplasty.