重睑联合内眦赘皮矫正术解剖探究及临床应用

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1、重睑联合内眦赘皮矫正术解剖探究及临床应用［摘要］目的：以内眦部解剖学研究为基础，探讨由重睑入路矫正内眦赘皮在临床中的应用。方法：对9具头部标本内眦部进行解剖研究及组织学观察，临床采用重睑切口，广泛分离内眦部，打断你内眦韧带与皮肤间的纤维连接，去除部分错构的眼轮匝肌，重建内眦结构，间断缝合重睑切口。结果：内眦韧带前支与覆盖其上的皮肤之间有明显纤维连接，在部分样本中可以观察到眼轮匝肌有跨越内眦韧带的现象。本组共矫正内眦赘皮42例，随访1〜6个月后，35例轻中度患者中31例得到明显改善，重度患者7例，

2、4例得到较大改善，所有病例术后均无明显瘢痕。结论：内眦赘皮是由内眦韧带至皮肤纤维连接及眼轮匝肌错构形成，经重睑入路的内眦赘皮矫正术在改善内眦赘皮的同时避免了内眦部瘢痕的产生，尤其适用于同时行重睑术的轻中度内眦赘皮患者。［关键词］内眦赘皮；解剖；内眦赘皮矫正术［中图分类号1R622E文献标识码］A［文章编号］1008-6455(2011)03-0379-03Anatomicstudyandclinicalapplicationoftheepicanthoplastycombinedwithblep

3、haroplastyGAOSha-shal,WANGYang2,C0NGGuo-hui2,TANGSheng-jianl,CAOJing-min2(1.ResearchInstituteofPlasticSurgery,WeifangMedical261042,Shandong,China；2.DrCaoCosmeticandPlasticSurgeryHospital,Jinan250014,Shandong,China)Abstract：ObjectiveAccordingtotheana

4、tomicstudyofthemedialcanthaltodiscussthetheclinicalapplicationoftheEpicanthoplastybydoubleeyelidapproach・MethodsAnatomicalandhistologicalstudyofthemedialcanthalof9preservedcadaverwereperformed.Weseparatedthemedialcanthalwidelytointerruptthefiberconne

5、ctionbetweenthemedialcanthalligamentandtheskin,thenremovepartsoftheorbicularisoculiwhichwalkingconfusedanddisorderlybyadoubleeyelidincision・ResuItsTherewasconspicuousfiberconnectionbetweentheanteriorbranchofthemedialcanthal1igamentandtheoverlyingskin

6、.Theorbicularismusclecanbeobservedacrossthemedialcanthal1igamentinsomesamples・Follow-upon42patientsafter1〜6months,31casesof35mildtomoderatepatientsweresignificantlyimproved,4casesof7severepatientsweregreatlyimproved,allcaseshadnoobviousscar・Conclusio

7、nitwasthereasonofepicanthusthatthefibersfromtheanteriorbranchofthemedialcanthalligamenttotheskinandtheorbicularisoculiwalkingconfusedanddisorderly.Theepicanthoplastybydoubleeyelidapproachcanbeusedtocorrecttheepicanthuswithoutthescarofthemedialcanthal

8、,especiallyformildtomoderateepicanthuspatientssimultaneouslywithblepharoplasty.Keywords：epicanthus；anatomy；epicanthoplasty蒙古人种的眼部形态特点主要为单睑、内眦赘皮、小睑裂、眼睑皮肤较厚，其中内眦赘皮更是较为明显的特征，据文献统计其发生率可达50%〜70%[1]。传统观念中轻度内眦赘皮是典型东方美的特征，但易给人无精打采的感觉，因而有较多求美者寻求内眦赘皮的矫正。但传统的内眦