皮下深层引导缝合悬吊法在小切口颞部除皱中的应用.pdfVIP

皮下深层引导缝合悬吊法在小切口颞部除皱中的应用 【摘要】目的：探讨一种简单易行的颞部除皱颞浅筋膜的悬吊方法。方法：站立平视， 标记悬吊线位置及方向。颞部发际内切口，皮下分离达眶外侧缘。利用皮下深层引导缝合悬 吊法悬吊颞浅筋膜(将导引器从颞部切口向前方插入皮下直达眶外侧缘，用三角针，1号丝 线从外眦外侧皮肤进针，在导引器中央穿过眼轮匝肌外缘及颞浅筋膜，然后从皮肤出针，取 下三角针，拖动导引器，将丝线从皮下引出切口，线的一端重新穿1/2弧圆针，缝合在切口 附近的颞深筋膜，调整悬吊的松紧度，满意后逐一打结)。结果：术后随访3-12个月，40 例患者术后效果良好，颞部松弛改善，眼角及眉下垂矫正，鱼尾纹减轻，无并发症发生。1 例患者3个月后出现两侧不对称，与悬吊线松脱有关，1例患者术后颞部紧绷不适感明显，3 个月后渐缓解。结论：借助于深部水平悬吊缝合导引器，颞浅筋膜悬吊过程简便易行，对周 围组织损伤较小，悬吊点定位准确，无需辅助切口或扩大切口，并可避免损伤面神经颞支， 值得临床推广使用。 【关键词】面部除皱术;颞部;小切口;皮下深层引导缝合悬吊法 Application ofthe methodof deep subcutaneously guiding suture intemple rhytidectomy Wang Shuqin, Tan Qian, Zhou Hongreng, et al. Affiliated Drum Tower Hospital, Nanjing University MedicalSchool, Nanjing,Jiangsu 210008, China Abstract：Objective：Toapproachasimpletemple rhytidectomytechnique by superficial temporal fascia suspension. Methods：To stand and orthophoria， mark location and direction of the suspension. Temple incision in hairline， abstraction subcutaneously to lateral margin of orbit. Use the method of deep subcutaneously guiding suture to suspend superficial temporal fascia(from smallincisionattempleto insertadeepsuspensionsutureguidingdevice under the skin flap，using triangular needle with 1#silk suture to stitch through the lateralskinofangulusoculilateralis,and runthroughtheorbicularis muscleand the superficial temporal fascia in the center of the guiding device, remove the needle, draw out the guiding device and educe the suture from incision subcutaneously. To fix at the profound temporal fascia near the incision with round needle according to the requirement of suspension) Result：All patients were followed up for 3-12 months . All cases obtained satisfactory results without serious complication. One patient appeared asymmetry at 3 months post operation. One patient complained that temple tightness discomfort had happened in 3 months postoperation. Conclusion：Using the method of deep subcutaneously guiding suture make the susp