孙士温　马杰　于晓锋　盛华　方建强　曹程程　程其远

[摘要]目的：探讨皮下脂肪-眼轮匝肌复合组织瓣修复上睑凹陷的设计方法、切取范围及其可行性。方法：2017年2月-2019年2月，选取18例患者，术前均诊断为上睑皮肤松弛合并上睑凹陷，改良设计了切眉方法，仅去皮，保留皮下脂肪，并与眼轮匝肌共同形成游离范围较大的复合组织瓣，将该组织瓣转移填充上睑凹陷区。结果：18例患者均得到了有效随访，最短3个月，最长2年。18例患者上睑凹陷得到明显改善或凹陷消失，无严重并发症，总体满意率94.4%。结论：对于上睑皮肤松弛合并轻、中度上睑凹陷的患者，在切眉术中应用皮下脂肪-眼轮匝肌复合组织瓣局部转移矫正上睑凹陷疗效满意，损伤小。

[关键词]眼轮匝肌瓣;真皮脂肪瓣;上睑凹陷;切眉术;眼睑成形术

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2020）08-0007-02

Application of Dermofat-orbicularis Oculi Muscle Combined Flap in Correction of Sunken Upper Eyelid

SUN Shi-wen，MA Jie，YU Xiao-feng，SHENG Hua，FANG Jian-qiang，CAO Cheng-cheng，

CHENG Qi-yuan

（Department of Medical Cosmetic，Fuyang City Peoples Hospital，Fuyang 236000，Anhui，China）

Abstract： Objective  To investigate the design method， cutting range and feasibility of dermofat-orbicularis oculi muscle combined flap for repairing upper eyelid depression. Methods  Dermofat-orbicularis oculi muscle combined flap transfer was performed in 18 patients with blepharochalasis and sunken upper eyelid， from February 2017 to February 2019. Browpexy was modified， the skin was only removed in excision zone， and then dermofat-orbicularis oculi muscle composite pedicled flap was formed. Transfer the flap to fill the area of upper eyelid sulcus. Results  All the 18 patients were followed up for 3 months and 2 years respectively. The depression of upper eyelid was improved or disappeared in 18 patients without serious complications. The overall satisfaction rate was 94.4%. Conclusion  Dermofat-orbicularis oculi muscle combined flap is an effective， predictable surgery for the correction of the mild to moderate blepharochalasis and sunken upper eyelid in browpexy.

Key words： orbicularis oculi muscle flap; dermofat flap; sunken upper eyelid; browpexy; blepharoplasty

上瞼皮肤松弛、眉下垂是衰老的常见临床表现。对于此类患者往往需要行提眉术或者切眉术。常规的手术操作是切除松弛多余的皮肤及上睑轮匝肌。笔者在工作中发现上睑皮肤松弛的患者同时合并上睑凹陷的情况十分多见。自2017年以来笔者尝试将原本需要切除的组织用来填充上睑凹陷，得到了满意的效果，现报道如下。

1  临床资料

本组共18例患者，男性3例，女性15例，年龄37～65岁，平均51岁，术前均诊断为上睑皮肤松弛合并上睑凹陷，凹陷程度轻度1例，中度16例，重度1例。

2  手术方法

2.1 术前设计：患者取坐位，睁眼平视前方，先画出切口上线。切口设计于眉下缘。……