加强眶隔前壁睑袋整复术.doc

加强眶隔前壁睑袋整复术[摘要]目的：探讨应用睑囊筋膜与眶隔的融合部缝合于下眶缘骨膜的弓状缘来加固眶隔进行睑袋整复术。 方法：在眼轮匝肌与眶隔之间分离，暴露眶隔。继续向下剥离，显露眶缘边缘上的厚骨膜即弓状缘后，在内侧再剥离到眶下缘下方1cm。用5-0无损伤线，把睑囊筋膜与眶隔的融合部连续缝合到下眶缘骨膜的弓状缘上。 结果：58例患者的远期效果良好，鼻颧沟或泪槽的凹陷畸形也得到部分改善。 结论：采用睑囊筋膜与眶隔的融合部缝合于弓状缘加固眶隔睑袋整复术，方法可靠、效果满意。 [关键词]睑囊筋膜；眶隔；弓状缘；睑袋整复术 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2008）05-03 reinforcing orbital septum for lower lid blepharoplaty DIAO Zhi-yong,WANG Xiao-li,SUN Yan-chang，SHANG Yong，YU Guang-zhe （Department of Plastic And Cosmetic Surgery，First Affiliated Hospital of Haerbin Medical University, Haerbin 150001,Heilongjiang，China） Abstract：ObjectiveTo explore the application of suturing the junction between capsulopalpebral fascia and orbital septum with arcus marginalis to reinforce orbital septum for lower lid blepharoplaty.MethodsThe plane of dissection was between orbicularis and orbital septum. Dissection continues inferiorly until periosteal cover of orbital rim came into view.The white arcus marginalis clearly appeared as thick periosteum on the edge of orbital rim.Medially,the dissection may be continued preperiosteally1cm beyond or below the rim. The junction between capsulopalpebral fascia and orbital septum was sutured with arcus marginalis.ResultsBulging fat was eliminated without overtreatment or undertreatment.Tear trough was improved substantially but not totally. ConclusionSuturing the junction between capsulopalpebral fascia and orbital septum with arcus marginalis to reinforce orbital septum for lower lid blepharoplaty is a safe, predictable, and effective treatment for bulging fat of lower eyelid. Key words:capsulopalpebral fascia；orbital septum；arcus marginalis；lower lid blepharoplaty 睑袋整复术是美容外科的常见手术。由于下睑皮肤肌肉及眶隔的松弛，眶隔脂肪的疝出形成睑袋。根据病因笔者采用肌皮瓣法，把睑囊筋膜或称囊睑筋膜(capsulopalpebral fascia)与眶隔的融合部缝合于下眶缘骨膜的弓状缘来加强眶隔，从而消除睑袋。自2000年～2007年对58例患者应用此术式,效果满意，现报道如下。 1临床资料 本组58例患者 ,男性23例 ,女性35 例，年龄33～72岁。其中5例曾作过睑袋整形术。 2手术方法 2.1 切口设计：按常规手术方法用美蓝标出距离下睑缘1～2mm的手术切口线,内侧抵达内眦角,外侧根据皮肤皱纹的多少由外眦角平行于皱纹线向外延伸3～8mm。 2.2 麻醉：2