经结膜入路释放并保留眶隔脂肪眼袋整形

发布时间：2019-04-14 18:22

【摘要】：背景：眼袋形成的原因很多,年轻患者多为遗传因素所致眶隔脂肪肥大、增生。随着年龄增长,下睑皮肤弹性降低,眼轮匝肌退行性改变,眶隔膜张力减弱,眶内脂肪经眶隔的薄弱区向前推移形成突出的眼袋。此外,眶下部浅层软组织受重力影响而向颊部下垂而使该部位软组织变薄,形成眶下缘凹陷沟槽。传统眼袋整形术一般采用经结膜入路及经皮肤切口入路两种术式,以去除眶隔脂肪改善外凸畸形为主。多数年轻患者属于下睑脂肪突出型眼袋、皮肤弹性良好、眶睑沟浅而窄,采用结膜入路术式去除疝出脂肪；中老年人除眼袋明显外,常伴有皮肤松弛、眶睑沟深而宽,从侧面观察呈现双凸型,仅切除眶隔脂肪将使下睑不平整,局部凹陷明显,眶睑沟更加显露,故目前多采用Hamra设计的经皮肤切口入路术式,保留并释放眶隔脂肪、提紧眼轮匝肌、切除松弛皮肤。目的：针对眶睑沟严重而下睑皮肤松弛不明显的眼袋类型,设计适用性较强的手术方法。方法：术前应先评估患者情况,了解患者对手术效果的期望,进而选择合适的经结膜入路术式,释放并保留眶隔脂肪的手术方法。结果：12例眶睑沟严重而下睑皮肤松弛不明显的眼袋患者以经结膜入路释放并保留眶隔脂肪术式,改善眼袋。术后经3-6个月以上随访,表明眼袋及眶、睑沟改善明显,无并发症出现。结论：针对眶睑沟严重而下睑皮肤松弛不明显的眼袋类型,采用经结膜入路术式,释放并保留眶隔脂肪的手术方法可以达到良好的效果。
[Abstract]:Background: there are many causes of ocular pouch formation. Young patients are mostly caused by genetic factors of orbital septum fat hypertrophy and hyperplasia. With age, lower eyelid skin elasticity decreased, orbicularis oculi muscle degeneration changes, orbital diaphragm tension weakened, intraorbital fat through the weak area of orbital septum forward to form prominent pouch. In addition, the superficial soft tissue of the lower orbital layer was caused by gravity to droop down to the buccal part, which made the soft tissue thin and formed the sag groove of the lower orbital margin. Traditional pouch surgery usually adopts transconjunctival approach and skin incision approach to improve the deformity of orbital septum fat. Most of the young patients belong to the lower eyelid fat protruding pouch, the skin elasticity is good, orbital sulcus is shallow and narrow, the conjunctival approach is used to remove hernia and fat; In addition to the obvious pouch, the middle-aged and old people are often accompanied by skin relaxation, deep and wide orbital eyelid sulcus, double convex type observed from the side, only excision of orbital septum fat will make the lower eyelid irregular, local depression obvious, orbital palpebral sulcus more exposed, At present, Hamra-designed skin incision approach is often used to preserve and release orbital septum fat, tighten orbicularis oculi muscle, and remove relaxed skin. Objective: in view of the orbital eyelid sulcus serious, the lower eyelid skin is not obvious loose eye bag type, designs the strong applicability operation method. Methods: the patient's condition should be evaluated before the operation, and the patient's expectation of the operative effect should be understood, and then the proper transconjunctival approach should be chosen to release and retain orbital septum fat. Results: the orbital pouch was improved by transconjunctival approach and the orbital septum fat was preserved in 12 patients who had serious orbital sulcus and the lower eyelid skin was not obviously relaxed. Follow-up for more than 3 months showed that the eyelid pocket, orbit and eyelid sulcus were improved obviously, and no complications occurred. Conclusion: according to the type of eyelid bag with serious orbital sulcus but the lower eyelid skin is not obviously loose, the method of transconjunctival approach to release and retain orbital septum fat can achieve a good effect. [WT5HZ] [WT5 "HZ] conclusion: [WT5" BZ]
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.6

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