上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2013, Vol. 33 ›› Issue (6): 842-.doi: 10.3969/j.issn.1674-8115.2013.06.029

• 论著（临床研究） • 上一篇    下一篇

应用双层瓦合肌瓣法进行眼袋整形的临床疗效观察

朱莉莉1，林威钢1，郑金满1，杨 军2   

  1. 1.浙江省临海市台州医院整形科， 临海 317000； 2.上海交通大学 医学院附属第九人民医院整复外科， 上海 200011
  • 出版日期:2013-06-28 发布日期:2013-06-28
  • 通讯作者: 杨 军, 电子信箱: yj55569@sina.com。
  • 作者简介:朱莉莉（1979—）， 女， 主治医师， 学士; 电子信箱: zhulili1013@163.com。

Clinical effect of double tile muscle flap method in pouch orthopedics

ZHU Li-li1, LIN Wei-gang1, ZHENG Jin-man1, YANG Jun2   

  1. 1.Department of Plastic and Reconstructive Surgery, Zhejiang Taizhou Hospital, Linhai 317000, China; 2.Department of Plastic and Reconstructive Surgery, the Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
  • Online:2013-06-28 Published:2013-06-28

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摘要：

目的 探讨外路法眼袋整形术中切口的设计、双层瓦合眼轮匝肌肌瓣的形成以及眶隔脂肪处理的重要性，观察双层瓦合眼轮匝肌肌瓣应用于眼袋整形的临床效果。方法 对388例下睑袋明显者，采取睑缘入口（外路法）手术，切口与外眦隐沟线平行，根据不同的临床表现，适当祛除或重置眶隔脂肪，缝合睑缘眼轮匝肌瓣与上提的肌皮瓣形成双层瓦合肌瓣，对合修整切口皮肤并缝合。结果 388例术后切口均一期愈合，整体效果满意，其中皮肤松弛明显者168例，颧面沟凹陷者62例，眶脂肪突出明显者158例，采用双层瓦合眼轮匝肌肌瓣，能保留更多下睑条状轮匝肌嵴，术后均无睑外翻发生。其中260例患者随访1~2年，下睑形态自然，未见明显手术瘢痕，无睑缘退缩。结论 在外路法眼袋整形术中，切口的设计、双层瓦合眼轮匝肌肌瓣的形成以及眶隔脂肪的恰当处理是手术成功的重要环节。

关键词: 眼袋, 睑缘入口, 眼轮匝肌肌瓣, 眶隔脂肪

Abstract:

Objective To explore the importance of design of incision, formation of double tile of orbicularis muscle flap and processing of orbital fat in extra-approach lower eyelid blepharoplasty, and observe the clinical effect of double tile of orbicularis muscle flap in pouch orthopedics. Methods Eyelid margin path (extra-approach) surgery was performed on 388 patients with obvious lower eyelid bags. The incision was paralleled with lateral canthus groove, and the orbital fat was removed or resected according to clinical manifestations. The eyelid margin orbicularis muscle flap and myocutaneous flap were sutured to form the double tile of muscle flap, and the wound was fit and sutured to close. Results Primary healing of incision was achieved in all the 388 patients, with satisfactory effect. There was obvious skin relaxation in 168 patients, zygomatic surface ditch sag in 62 patients, and prominent orbital fat in 158 patients. Double tile of orbicularis muscle flap was adopted, more lower eyelid strips of orbicularis muscle crest were retained, and no ectropion occurred after operation. Two hundred and sixty patients were followed up for 1 to 2 years, the morphous of the lower eyelid was natural, and no significant surgical scar and palpebral retreat was observed. Conclusion The design of incision, formation of double tile of orbicularis muscle flap and processing of orbital fat are critical steps for extra-approach lower eyelid blepharoplasty.

Key words: under-eye puffiness, palpebral entrance, orbicularis muscle flap, orbital fat