睑袋整复术中眶隔脂肪瓣翻转填充对矫正眶下沟槽畸形的作用

Application of orbital septal fat flap in the correction of deformities of the lower orbital groove in blepharoplasty

目的介绍睑袋整形术中处理眶隔及眶隔脂肪并充分矫正宽大泪沟和睑颊沟的方法。方法自2016年7月至2017年11月,共35例患者接受眶隔脂肪瓣翻转填充法睑袋整形术。术中完整显露眶隔后,将眶下剥离范围延伸到距眶缘1 cm,在眶隔上缘将眶隔剪开后形成蒂在上的向下翻转的脂肪瓣,充分填充泪沟与睑颊沟基底。结果本组共35例患者,术后随访4～12个月。睑袋畸形及泪沟、睑颊沟显现等体征均得以矫正,眶周及中面部较术前明显年轻,远期无下睑凹陷、外翻或巩膜过分显露、睑球分离、眶下神经支配区域麻木疼痛等并发症发生,效果满意。结论眶下沟槽区域充分剥离同时眶隔脂肪瓣翻转填充对较重泪沟以及睑颊沟的患者改善较明显,值得推广。

Objective To introduce the method of treating the orbital septum, orbital septal fat,and full correction of the broad lacrimal sulcus and the eyelid buccal sulcus in lower lid blepharoplasty. Methods From July 2016 to November 2017, a total of 35 patients received orbital septal fat flap during blepharoplasty. During the operation, the orbital septum was completely exposed and the suborbital stripping range was extended to 1 cm from the cc. After incising the orbital septum at the superior margin, a downward turning fat flap with a pedicle on top was formed. The lacrimal sulcus and eyelid buccal sulcus were fully filled. Results All patients were followed up from 4 to 12 months postoperatively. The eyelid sac deformity, obvious lacrimal sulcus and eyelid buccal sulcus were corrected. The periorbital and middle face had a more youthful appearance than preoperatively. There were no complications such as lower eyelid depression or exstrophy, scleral overexposure, eyelid ball separation, numbness or pain of the suborbital innervation region. The results were satisfactory.Conclusion Fully stripping the suborbital groove while overturning and filling the orbital septal fat flap can obviously improve the appearance of patients with severe lacrimal sulcus and eyelid buccal sulcus. This procedure is worth promoting in clinic.