眶外缘眼轮匝肌舒平悬吊法在除皱术中应用.docVIP

眶外缘眼轮匝肌舒平悬吊法在除皱术中应用[摘要]目的：探讨除皱术中应用眶外侧眼轮匝肌舒平悬吊法矫正鱼尾纹和外眼角下垂的效果。方法：除皱术中采用眼轮匝肌浅面分离至外眦，彻底松解鱼尾纹；再将眶外侧眼轮匝肌外缘向外、上方舒平并悬吊至颞浅筋膜，矫正鱼尾纹和外眼角下垂。结果：此法2003-2010年临床应用591例。就医者随访2～51个月，鱼尾纹和外眼角下垂改善效果明显，无并发症。结论：此手术方法操作简单，有效矫正了鱼尾纹和外眼角下垂，是一种行之有效的除皱方法。 [关键词]眼轮匝肌；悬吊；舒平；除皱术 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2011）04-0555-02 Application of orbicularis oculi flattening and suspension technique for rhytidectomy WANG Tai-ling,WANG Jia-qi,GUO Xin,YU Hao,ZHENG Xing-yue,SONG Wei-ming,YANG Wen-shuang, WU Jia-jun,ZOU Chong,XUE Wen-li (The Third Department of Plastic Surgery Hospital,Chinese Academy of Medical Science Peking Union Medical College,Beijing 100144,China) Corresponding author: WANG Jia-qi Abstract:ObjectiveTo approach the aesthetic outcome of crow’s-feet and lateral canthus ptosis correction using orbicularis oculi flattening and suspension technique in rhytidectomy.MethodsSharp dissection the crow’s-feet continued above the orbicularis oculi till the lateral canthus, then flatten the orbicularis oculi and suspended itsuperolateral to the superficial temporal fascia to correct the crow’s-feet and lateral canthus ptosis.Results591 patients were treated from 2003 to 2010. The follow-up period ranged from 2 to 51 months. Remarkable improvement achieved in the crow’s-feet and lateral canthus ptosis. No complications appeared.ConclusionsThis method which has easier operation is very effective in crow’s-feet and lateral canthus ptosis correction. Key words:orbicularis oculi;suspension;flattening;rhytidectomy 成年女性一般在30岁左右开始出现外眼角皱纹，俗称“鱼尾纹”。鱼尾纹属动力性皱纹，系面部相应部位表情肌习惯性反复收缩所致，可随着年龄增加、皮肤软组织松垂而逐渐加重，并常合并外眼角下垂。目前常规的手术和非手术方法虽可取得一定的效果，但往往矫正不彻底，持久性欠佳。为此，笔者经过7年的探索，对591例除皱就医者联合应用了眶外侧眼轮匝肌舒平悬吊术矫正鱼尾纹和外眼角下垂，取得比较好的临床效果。 1手术方法 以颞部除皱为例。常规颞部切口，切开，皮下分离(即颞部在颞浅筋膜浅层分离，达眼轮匝肌外缘部位在眼轮匝肌浅面分离)，向内达外眦，彻底分离眼轮匝肌和真皮连接，可有效减轻鱼尾纹。在颞部切口后缘前方1cm切开颞浅筋膜，在颞浅筋膜深面钝性分离达眼轮匝肌外缘。将颞浅筋膜瓣向外上方提紧，应用1号丝线将其与切口后缘的颞浅筋膜折叠缝合。用3-0可吸收线将眼轮匝肌外缘向外、上方向展平、提紧，在外眦水平及其上下1.5cm水平设计三点，将三点悬吊固定于切口后缘的颞浅筋膜层，上提外眼角并进一步解决鱼尾纹（图1）。上提固定的方向和力度应视就医者