“埋没导引”低位外固定技术在经结膜入路眶隔脂肪重置术中的应用

The application of"the needle-guided low external fixation technique"in the intraconjunctival incision of lower eyelid pouch with tear trough deformity

目的探讨“埋没导引”低位外固定技术在经结膜入路眶隔脂肪重置中的应用效果。方法回顾性分析自2022年10月至2023年10月,河南电力医院整形美容外科就诊并要求下睑综合治疗42例求美者的临床资料。在经结膜入路睑袋去除和眶隔脂肪重置填充泪沟手术中实施“埋没导引”低位外固定技术,以有效地预防已释放的眶隔脂肪瓣再次回弹至眶隔前间隙形成睑袋。术后随访观察并统计释放后带蒂的眶隔脂肪瓣向上回弹率和并发症情况。结果42例求美者术后睑袋膨出和泪沟凹陷得到明显改善。12例术中麻醉药物注射时出现球结膜出血,无特殊处理2周后好转;2例术后2周静态无面部表情时双侧下睑区域平坦,而做剧烈面部动态表情时出现下睑区域疑似睑袋膨出,未给予特殊处理;2例在术后前2个月表示仍有下睑牵拉感,未给予特殊处理后消失。所有患者术后随访3~12个月,无一例出现释放眶隔脂肪回弹至眶隔前间隙重新形成睑袋膨出。高年资医师、护士、求美者三方评价满意率分别为90.48%、95.24%、85.71%。结论在经结膜入路眶隔脂肪重置手术中实施“埋没导引”低位外固定技术,术后能获得较满意的下睑形态外观,对睑袋膨出和泪沟凹陷具有较好的矫正效果,且释放的眶隔脂肪重新回弹形成睑袋的概率较低,医患双方满意度较高。

Objective To investigate the application effect of"buried-guidance"lowexternal fixation technique in the transconjunctival orbital septum fat reset blepharoplasty.Methods From October 2022 to October 2023,the clinical datas of patients who requested comprehensive treatment of lower eyelid were retrospectively analyzed.The"buried-guidance"lowexternal fixation technique was applied in the transconjunctival orbital septum fat reset blepharoplasty.This technique effectively prevented the release of the orbital septum fat flap from returning to the preseptal space to form a pouch.The upward rebound rate and complications of the pedicled orbital septum fat flap after release were observed and analyzed.Results There were significant improvements in the lower eyelid pouch and the tear groove in 42 cases.Twelve cases of intraoperative conjunctival hemorrhage occurred during anesthetic injection,which improved after 2 weeks without special treatment.In 2 cases,the bilateral lower eyelid area was flat when there was no facial expression 2 weeks after operation,while the lower eyelid area was suspected to be loweyelid pouch when there was intense facial dynamic expression,without special treatment.Two patients still had lower eyelid drag sensation at the first 2 months after surgery,which disappeared after no special treatment.All patients were followed up for 3 to 12 months after surgery,and none of them released orbital septal fat to rebound into the preorbital space to re-form lower eyelid pouch.The satisfaction rates of the senior doctor,nurse and beauty seeker were 90.48%,95.24%and 85.71%,respectively.Conclusion The application of"buried-guidance"lowexternal fixation technique in transconjunctival orbital septum fat reset blepharoplasty can achieve a flat lower eyelid appearance,and has a good correction effect on pouch and tear trough depression.The incidence of orbital septum fat rebound to formpouch is low,and the satisfaction of both patients and doctors is high.