改良肌皮瓣法结合眶隔固定术进行眼袋整形的临床效果观察

目的观察和探讨改良肌皮瓣法结合眶隔固定术进行眼袋整形的效果。方法 312例受术者分为2组,每组156例,A组受术者分别设计去皮宽度,切开下睑皮肤,分离出上端为皮瓣的肌皮瓣,并成型眶隔表面肌肉瓣,切开并复位固定眶隔后,向上提紧缝合肌肉瓣,适当去皮,对合修整切口皮肤并缝合。B组采用传统肌皮瓣眼袋整形术。结果术后随访36个月,结果显示:结合了改良肌皮瓣法和眶隔固定术的眼袋整形术在对眼袋、下睑皮肤皱纹、鼻泪沟改善的远期效果明显优于传统肌皮瓣眼袋整形术(P<0.01),且不会出现下睑凹陷。结论改良肌皮瓣法结合眶隔固定术行眼袋整形能恢复下睑解剖结构,使术后效果自然、持久,是一种适应证广,并发症少,操作清晰的改良术式。

Lower blepharoplasty by modified myocutaneous flap and septum orbitale fixation:a report of 312 patients

Objective To determine the plastic outcome of lower blepharoplasty by modified myocutaneous flap and septum orbitale fixation.Methods A total of 312 patients undergoing plastic surgery for under-eye puffiness in our department from April 2003 to April 2008 were randomly divided into 2 groups,experimental group(group A)and control group(group B).In group A,patients were operated with following procedures in turn,incision design,make incision and free myocutaneous flap with skin flap superiorly,free muscle flap on the surface of septum orbitale,open and fix septum orbitale on the periosteum of infraorbital margin,muscle flap was also fixed to septum orbitale with tension,then resect extra skin,fit and suture to close the wound.In group B,patients were operated with traditional myocutaneous flap lower blepharoplasty.Results Post-operative follow-up was made for 36 months.When compared with traditional myocutaneous flap lower blepharoplasty,our new technique had significant advantages,including long-lasting effectiveness on improving eye pouch,skin wrinkles and nasolacrimal groove,and preventing post-operative inferior eyelids depression(P<0.01).Conclusion This modified lower blepharoplasty can reset lower eyelid anatomic structure,and provide natural,long-lasting effect.It is a modified surgical technique with much more indications,much less complications,and clear procedures.