摘要
【摘要】目的通过对泪槽区域进行解剖学研究，探讨泪槽畸形老化特征的发生机制。方法选取13具（26侧）10％甲醛固定的成人尸头标本，其中男性9具（18侧），女性4具（8侧），年龄22～78岁。以显微手术器械，在10×解剖显微镜下逐层解剖眼周，重点解剖泪槽区域，观察并描述各区的解剖学层次。解剖并显露下睑眼轮匝肌支持韧带，认真记录支持结构的解剖学位置并照相保存。结果①泪槽区域的解剖层次分为：皮肤层、皮下组织层、眼轮匝肌层、骨膜层，泪槽以上皮肤层下为无脂肪区，泪槽以下皮肤层下为有脂肪区，其脂肪为颧脂肪垫。②下睑眼轮匝肌眶隔部与眼轮匝肌眶部在眶骨内侧表面有自然的分界线，其体表投影对应于泪槽，该分界在内眦角垂线上的宽度为（2．06±0．15）mm，在鼻翼外缘垂线上的宽度为（3．25±0．12）mm，眼轮匝肌眶隔部与眼轮匝肌眶部在距内眦角（16．56±0．51）mm处开始融合。③眶内侧、眶上下侧有眼轮匝肌支持韧带，眶外侧无眼轮匝肌支持韧带。下睑眼轮匝肌支持韧带分为2层。④下睑眼轮匝肌支持韧带上层内侧起于眶缘，向外在距眶外缘以内（16．10±0．43）mm处起于眶骨前壁，韧带穿过眼轮匝肌止于皮肤。下睑眼轮匝肌支持韧带下层起于眶骨前壁，穿过眼轮匝肌及眼轮匝肌浅面的脂肪层止于皮肤。结论泪槽的水平长度为（16．56±0．51）mm，泪槽在内眦角垂线及鼻翼外缘垂线上的宽度分别为（2．064-0．15）mm、（3．25-±O．12）mm。泪槽畸形的形成原因主要是下睑眼轮匝肌支持韧带松弛，导致其下层穿过的脂肪下降或萎缩，使眼轮匝肌支持韧带上下层之间距离增大所致。
Objective To explore the mechanism of the aging deformity of tear trough through the anatomic study of the tear trough region. Methods 13 adult cadaveric heads （26 sides） , including 9 male heads（18 sides） and 4 female heads（8 sides）, aged 22-78 years old, were used. Anatomic study was performed around the orbital, especially tear trough region, with microsurgery instrument under microscope（ x 10 times）. The lower orbicularis retaining ligament was dissected and exposed. The anatomic location was recorded and photographed. Results （~）The anatomic layers of the tear trough region contains skin, subcutaneou tissue, orbicularis oculi muscle, periosteal membrane. There is no subcutaneous fat above the tear trough, while it exists below the tear trough, called malar fat pad. （~）There is a natural boundary between the septal and the orbital portions of the orbicularis oculi muscle of lower eyelid at surface of the orbital bone. The natural boundary, projected on the body surface corresponds to tear trough. The width of boundary is （2. 06 ~ 0. 15） mm on the vertical line through inner canthus and （3.25 -sO. 12） mm on the vertical line through the lateral margin of the ala. The septal portion and the orbital portion of the orbicularis oculi muscle began to merge in（ 16.56 ~ O. 51 ） mm to inner canthus. There is ligament attachment in the medial, upper and lower orbital and no ligament attachment in the lateral orbital. Orbicularis retaining ligament of lower eyelid is divided into two layers. The medial of the upper layer of the orbicularis retaining ligament in lower eyelid originates from orbital margin and from
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2014年第1期50-53,共4页
Chinese Journal of Plastic Surgery
