内镜辅助下额颞部除皱上提术

目的为了避免传统的额颞部冠状除皱手术造成的瘢痕、脱发、头皮麻木、血肿等并发症，探讨和解决内镜下额颞部除皱手术的相关问题。方法采用额颞部发际内3（或5）个小切口，额部在骨膜下或者帽状腱膜下以及颞部在颞深筋膜浅层剥离，额颞部剥离腔在颞嵴处贯通。在内镜下显露并处理皱眉肌、降眉肌、额肌以及眼轮匝肌。在眶周骨膜下充分剥离，游离并上提额颞部皮肤，在额部和颞部分别固定。结果186例，除3例出现单侧面神经额支暂时性麻痹，5例出现眉问以及外侧眼角局部凹陷，经过注射脂肪处理以外，其余均获得满意效果。结论内镜辅助下额颞部除皱手术具有微创、出血少、并发症少、手术效果稳定等优点，与传统冠状切口手术方法相比，具有广阔的发展前景。

Endoscopically assisted forehead lift

Objective To avoid the complications such as scar,alopecie,scalp numbness,hematoma etc,resulted from the conventional coronal incision rhytidectomy,and to explore and solve the issues about endoscopic frontal and temporal rhytidectomy.Methods Through 3-5 short incisions in hairline,we dissected under frontal periosteum or gales aponeurotica and in superficial layer of deep temporal fascia.The frontal and temporal cavitites were feedthrough at temporal crest.The corrugator supercilii muscle,superciliary depressor muscle,frontal muscle and orbicularis oculi were treated.Sufficient dissection was done under the periosteum of os orbitale.Results This method had been applied in 186 patients with forehead lift.After operation,transient paralysis of facial nerve frontal branch were found in 3 patients.The depression of glabellum and lateral canthus were found in 5 patients.The depressions were corrected by autologous fat injection. Other 178 patients' results were satisfactory.Conclusions Endoscopic frontal and temporal rhytidectomy has some advantages,such as minute invasion,less hemorrhage,few complications,and stable operation result,etc.Compared to the conventional coronal incision rhytidectomy,this method will be used more widely.