人体眶周脂肪注射的应用解剖

Applied anatomy of human periobital region

目的观察人体眶周主要区域的解剖层次和重要血管结构,为临床眶周脂肪注射提供一定的解剖学依据。方法2018年1月至12月,选取12具(24侧)尸体标本(郑州黄河科技大学解剖学实验室提供),男性6具,女性6具,年龄(47.5±11.7)岁,对其眶周组织进行常规和显微解剖,通过电子游标卡尺对眶周重要血管和组织结构进行测量,并结合文献分析脂肪注射填充时的相关注意事项。结果眶周的主要结构区域包括眼睑区、眉部、泪槽畸形,眼睑区皮肤厚度为(0.09±0.03)mm,眉部皮肤厚度为(3.45±0.38)mm,血管分布丰富,血管内径为1~3 rrnn,鼻背动脉、滑车上动脉和眶上动脉内径分别为(0.73±0.42)mmJO.88±0.37)mm和(0.71±0.51)mm,面动脉、上颌动脉和颍浅动脉内径分别为(2.96±0.88)mm.(1.92±0.33)mm和(1.35±0.15)mmo结论上眼睑脂肪注射入口一般选择在眉尾或眉中部,于眼轮匝肌深面注入,注射范围仅限于上眼睑内侧2/3、眉毛下内侧1/3和眉毛外侧部分,建议单层微量(0.5-1.5 ml)注射。下眼睑脂肪移植主要是矫正眼睑颊部交界处的畸形,注射时可以用钝针在畸形内、外、中部进入,在睑颊沟区将脂肪注射于眼轮匝肌下脂肪垫(SOOF)层或骨膜前,注射量0.5-1.0 ml.

Objective To observe the anatomical layers and important vascular structures in themain periorbital regions of the human body, and to provide some anatomical basis for clinical periorbital fatinjection. Methods During January 2018 to December 2018, 12 ( 24 sides) cadavers ( 6 males and 6females, 47. 5 ± 11.7 years old ) were selected. Their orbital tissues were dissected routinely andmicrodissected. The important blood vessels and tissues around the orbit were measured by electronicvernier caliper. The related matters needing attention in fat injection filling were analyzed according toreferences. Results The main structural areas around the orbit included eyelid, eyebrow and lacrimalgroove deformities. The thickness of eyelid skin was (0. 09±0. 03) mm. The thickness of eyebrow skin was(3. 45±0. 38) mm. Vascular ( diameter ranged from 1 mm to 3 mm) distribution was abundant in this area.The inner diameter of dorsal nasal artery, supraorbital artery and trochlear artery were ( 0. 73±0. 42) mm,(0. 88±0. 37) mm and ( 0. 71 ± 0. 51 ) mm respectively. Facial artery, maxillary artery and superficial temporal artery with internal diameters of ( 2. 96±0. 88) mm , ( 1. 92±0. 33) mm and ( 1. 35±0. 15) mm ,respectively. Conclusions The entrance of upper eyelid injection is usually in the eyebrow tail or middleeyebrow , and fat is injected into the deep surface of orbicularis oculi muscle. The injection range is limitedto the medial 2/3 of upper eyelid, the medial 1/3 of lower eyebrow and the lateral part of eyebrow. It issuggested that single layer microinjection of fat ( 0. 5 ml to 1. 5 ml) could be used. Lower eyelid fattransplantation is mainly used to correct deformities at the eyelid-cheek junction. The aim is to reduce theV-shaped deformity at the eyelid-cheek junction by increasing the fullness. Injection can be made by bluntneedle into the inner, outer and middle part of the deformity. Fat can be injected into SOOF layer orperiosteum in the palpebral and cheek sulcus area. The injection volume is 0. 5- 1. 0 ml.