眶肌筋膜韧带提紧——眼袋整形的新思路

Fascia ligament of orbital muscle slinga new ideal for lower eyelid blepharoplasty

目的 研究眶肌筋膜韧带提紧的眼袋整形方法 ,进行东方人种眶肌筋膜韧带的解剖研究 ;方法 进行眶肌筋膜韧带的解剖观察 2 0例。在临床上进行眶肌筋膜韧带提紧眼袋整形 2 0 4例 ,手术中应用下睑睫毛下 1mm皮肤切口 ,摘除下眶隔脂肪 2～ 3块 ,切除皮肤及眼轮匝肌 3～ 1 0～ 1 5mm。结果 解剖显示人眶肌筋膜韧带是眶隔筋膜外侧部分增厚的膜状纤维韧带结缔组织结构 ,位于眶外侧脂肪囊的外侧 ,该韧带在冠状面上 ,位于眼外眦角内侧 ,浅面紧贴眼轮匝肌深面 ,深面附着在下眼睑睑板下方 ,韧带长 1 5mm ,宽 1 2mm。剪断眶肌筋膜韧带 ,将筋膜韧带与外眦韧带或眶外缘骨膜固定 ,达到眼轮匝肌提紧 ,眶筋膜提紧及下眼睑皮肤松弛矫正 ,从 1 998年 1 0月 ,到 2 0 0 0年 8月 ,在临床上进行的眶肌筋膜韧带提紧眼袋整形 2 0 4例中 ,其中 5例 ,手术后几天里发生轻微睑外翻 ,拆线后恢复良好。大部分手术者经过 2周到 2年的随妨 ,手术后取得了良好效果。结论 眶肌筋膜韧带提紧眼袋整形 ,特别对于 40岁以上的患者较为适用 ,它既可避免单纯眶隔筋膜提紧少数人手术后造成的下睑缘僵直 ,又可避免单纯眼轮匝肌提紧手术后少数人留有外眦角硬结 ,或凹陷或睁眼易疲劳感。

Objective To study the anatomy of fascia ligament of orbital muscle and itsapplication for the primary or secondary lowers eyelid blepharoplasty. Method To observe the anatomy of fascia ligament of orbital muscle in 20 cases; and using the fascia ligament of orbital muscle sling for lower eyelid blepharoplasty with traditional surgical approaches to the aging lower eyelid utilize the incision 1mm under eyelash of lower eyelid, take out two to three pieces of orbital fat, cut 3～10～15 mm a part of musculi orbicularis oculi and lose skin of lower eyelid in 204 cases.Results The anatomy shows that the fascia ligament of orbital muscle is a fascia fiber ligament. It located at lateral of lateral orbital fat compartment under the musculi orbicularis oculi and medial of outer canthus.The length of the ligament is about 15 mm.and width around 12 mm.To cut the fascia ligament of orbital muscle and fix the fascia ligament with the outer canthus ligament or orbital periosteum may sling musculi orbicularis oculi and tighten the fascia ligament of orbital muscle and the loose skin of lower eyelid. This series of 204 cases of fascia ligament of orbital muscle sling to the lateral canthus for lower eyelid blepharoplasty have performed from October, 1998 to August, 2000.There were 5 cases which occurred ectropion in the few days postoperatively. All of them have got good results followed through two weeks to two years post operation. Conclusion The fascia ligament of orbital muscle sling is a new ideal for lower eyelid blepharoplasty, compare with outer canthus nodule and tireness after musculi orbicularis oculi lifting or stiffness after obital fascia lifting, especially for cases over 40 years old.