内眦蒂眼轮匝肌瓣在眶缘凹陷睑袋整复术中的应用

目的 探讨睑袋整复术中眼轮匝肌瓣的转位利用和效果.方法 在经皮肤入路下睑袋整复术中,还纳疝出的眶隔脂肪,将眶隔膜收紧缝合固定于眶缘.提紧眶肌筋膜韧带,将多余的松弛眼轮匝肌形成内眦蒂肌皮瓣,转位填充于眶下缘与睑囊筋膜之间.结果 自2006年3月至2008年7月,共施术97例,3例术后内眦部小丘状隆起,1～2个月恢复;2例下睑区硬化,经局部热敷、按摩,2～3个月软化;1例出现轻度的睑球分离,2个月后自然恢复.其中93例患者获随访3～15个月,均获得了满意的效果,睑袋、眶缘凹陷均得以矫正,睑颊过渡区恢复年轻态,无皮下索状隆起和异物感,无下睑退缩、睑外翻等并发症发生.结论 内眦蒂眼轮匝肌瓣在修复眶缘凹陷的同时,加强眶隔膜作用,恢复眶前壁的张力,进而恢复年轻化的眶区生理结构,效果理想持久.

Repair of lower eyelid blepharoplasty with orbital margin depression by orbicularis oculi muscle flap of inner canthus pedicle

Objective To explore the effect of transposition of orbicularis oculi muscle flap on the lower eye-lid blepharoplasty. Methods During the lower eyelid blepharoplasty, orbital septum fat was replaced and orbital septum fascia was sutured on the orbital margin. Lifted the orbital muscle facia ligament, then the redundant and loose eyelid orbicular muscle was used to form the musculocutaneous flap of inner canthus pedicle which was trans-planted and sutured between infraorbital border and palpebralis fascia. Results From March 2006 to July 2008, 97 cases were operated. In which, 3 cases got nodule eminence at inner canthus which recovered after 1～2 months; 2 cases had longer period of hardening at lower eyelid which became soft by regional fomentation and chirapsia after 2 ～3 months; 1 case got lower grade eyelid-ball disconection which recovered naturally after 2 months. Ninty -three cases were followed up for 3～15 months, all of them had satisfactory results postoperatively. The baggy lower eyelid and introcession on the orbital margin were normolly rectified, and had a better effect on face lifting and rejuvenation of the orbital area with no nodule leminenee and foreign body sensation. Also, no case had lower eyelid recession or lower eyelid ectropion. Conclusion The orbicularis oculi muscle flap of inner canthus pedicle can strengthen the contribution of the orbital septum fascia regain the tension of the anterior wall of fossa orbitalis, then refect the phys-io-constitufion of the orbital area in the operation of the lower eyelid blepharoplasty with orbital margin introcession so that it can get a long time result.