硅胶假体充填颞部的体会

Experience in silicone implants filled with temporal portion

目的：探讨硅胶假体充填颞部的临床应用效果。方法：首先设计充填范围，即在填充物画线外扩大0.3 cm；假体修整，做到长宽、厚度到位，边缘渐薄，使其与组织帖服，外观平滑整洁，而无异物感；以靠近颞部凹陷处，沿着鬓角发际内1.0 cm，顺发纹作以1.0~1.5cm 手术切口，直接行皮下分离，或作颞浅筋膜深面分离，钝锐结合以钝为主进行分离；以刀柄顶端摊平假体，或通过扩大腔隙，或用直针掛线法将假体置入腔内，以使假体摊平，再行创口单层缝合；术后加压包扎至少48小时，服用抗生素3天，3~4周拆线。结果：术后切口均一级愈合，无一例感染。随访3个月~2年，外观均有明显改善，面上部轮廓柔和饱满，鱼尾纹减少，而显得年轻，术者满意度较高。8例术者因术后2周~1月局部出现不同程度胀痛感，行手术取出假体。结论：本手术所采用的硅胶假体填充术，矫治颞部凹陷是一种求美者易于接受，且安全、经济、有效的手术方法。

Objective To investigate the clinical application of silicone implants filled with temporal portion. Method First design fill-ing range,namely the expansion of the filler 0. 3 cm draw a line outside;prosthetic repair,so the length and width,thickness in place,the edges tapered to match the organization docile,smooth and clean appearance,no foreign body sensation;In close temporal depression,a-long sideburns hairline 1. 0 cm,along the hairline as to 1. 0 ~ 1. 5 cm incision,direct line separating the skin,or for superficial temporal fascia deep surface separation,blunt sharp combine to blunt the main separation;to handle top smoothing prosthesis,or by expanding cavi-ties,or straight needle and thread prosthesis implantation cavity so that the prosthesis smoothing,re - wound single suture;surgery plus pressure bandage at least 48 hours,taking antibiotics three days,three to four weeks stitches. Results A healing incisions,no case of in-fection. Follow - up of 3 months to 2 years,the appearance were significantly improved,the surface contour soft plump,reduce wrinkles, and look younger,higher surgeon satisfaction. 8 cases of the surgeon because after 2 weeks to a month varying degrees of local sense of pain,surgical removal of the prosthesis. Conclusion The surgery used to fill silicone prosthesis surgery,treatment of temporal depression is an easy to accept for the United States,and the safe,economical and effective surgical method.