摘要
目的探讨一种基于上颌前间隙及颧前间隙的眶隔脂肪重置,结合口腔前庭切口内固定纠正睑袋和泪沟畸形的临床效果。方法回顾性分析2018年8月至2019年2月上海第九人民医院整复外科收治的17例睑袋伴泪沟畸形病例的临床资料,其中男2例,女15例,年龄(36.9±8.8)岁(24~55岁)。经结膜作1.0~1.5 cm的横行切口,将眶隔脂肪带蒂游离,分离相应的上颌前间隙和部分颧前间隙,将1~2根可吸收缝线缝合固定在眶隔脂肪游离缘,通过长针经上述间隙穿出到口腔前庭上唇侧所作的同一个小切口,将脂肪下拉到医、患双方都满意的曲线部位,在口腔前庭小切口内打结固定,切口均无需缝合。结果术后随访(3.53±1.71)个月(1~6个月),结膜切口及口内切口愈合良好,患者睑袋、泪沟畸形均得到明显改善。2例患者术后1周出现中面部一过性牵拉感,1~2周后恢复正常;1例患者术后1个月出现右侧鼻翼旁皮肤红肿、疼痛,静脉滴注头孢拉定,3日后症状消失;未出现下睑退缩、睑外翻、血肿等并发症。结论对于各年龄段睑袋伴有泪沟畸形及中面部凹陷、无严重下睑皮肤松弛的患者,该术式可以更有效地纠正睑袋和泪沟畸形,改善中面部轮廓,达到年轻化目的。
Objective To explore and evaluate the approach of fat repositioning into premaxillary and prezygomatic spaces combined with intraoral fixation in transconjunctival lower blepharoplasty.Methods 17 patients(2 males and 15 females)who underwent this approach from Aug,2018 to Feb,2019 were reviewed.Their average age was 36.88±8.80 years old(range,24 to 55 years old).A 1.0-1.5 cm transverse transconjunctival incision was made.After blunt dissection of premaxillary and prezygomatic spaces,orbital fat were released and sutured with 1-2 absorbable sutures.Via the guidance of astraight needle through the a forementioned spaces,a small incision was made at the upper vestibular labial side.The orbital fat was pulled down according to the consensus between surgeon and patient and fixed upon the small intraoral incision.All incisions didn′t need to be sutured.Results The mean follow up was 3.53±1.71 months(range,1 to 6 months),transconjunctival and intraoral incisons healed well.Palpebral bags and tear trough deformity were obviously improved.Postoperatively,2 patients felt a transient tractive feeling in the midface region 1 week after surgery,which spontaneously recovered within 1 to 2 weeks.One patient had red,swollen and painful skin beside the right nasal alar one month after the operation,and the symptoms disappeared after 3-day intravenous infusion of cefradine.No lower eyelid retraction,ectropion,hematoma and other complications were observed.Conclusions This novel approach can achieve periorbital rejuvenation and improve the contour of the lower eyelid and mid-face for patients of all the ages with eyelid bags,tear trough deformity,and midfacial depression,but without severe skin laxity.
作者
高玮
林晓曦
金云波
陈辉
乔丛蓁
张世仁
胡丽
邹运
仇雅璟
Gao Wei;Lin Xiaoxi;Jin Yunbo;Chen Hui;Qiao Congzhen;Zhang Shiren;Hu Li;Zou Yun;Qiu Yajing(Department of Plastic and Reconstructive Surgery,Ninth People’s Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200011,China)
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2019年第12期1240-1245,共6页
Chinese Journal of Plastic Surgery
关键词
睑袋
泪沟畸形
下睑成形术
脂肪重置
Eye bags
Tear trough deformity
Blepharoplasty of lower eyelid
Fat repositioning
