The Lateral Orbital Thickening and the Lateral Brow Thickening: A New Choice for the Lower Eyelid Suspension

医学 眼睑 增稠 解剖 外科 眼轮匝肌 尸体 化学 高分子科学
作者
Cheng Huang,Xing Huang,Rui Jin,Di Sun,Lin Lü,Xi Wang,Jun Yang,Chuan Gu,Xusong Luo
出处
期刊:Journal of Craniofacial Surgery [Lippincott Williams & Wilkins]
卷期号:33 (6): 1748-1753
标识
DOI:10.1097/scs.0000000000008718
摘要

This study aimed to evaluate the effectiveness and safety of a double-suspension technique using the lateral orbital thickening (LOT) and the lateral brow thickening (LBT) in patients with lower eyelid defects. A total of 5 cadavers (4 males and 1 female) ranging in age from 50 to 78 years was subjected to observe the distribution of the orbicularis retaining ligament (ORL) and its characteristics. The ORL is a closed-loop structure that forms the LBT outside the supraorbital rim and forms the LOT in the lateral canthal region. A total of 17 patients (12 females and 5 males) with an average age of 12.3 years who underwent the ORL-assisted lower eyelid reconstruction were included in this retrospective study. After the ORL was completely released on the infraorbital rim for reducing down traction, the subocularis oculi fat and the orbicularis oculi were fixed to the LBT and the LOT for increasing the upward traction. The lower eyelid defects in 17 patients were reduced in different degrees. The defects were closed directly in 3 patients and were resurfaced by skin graft or flap in the other 14 patients. Physicians and patients were all satisfied with the final cosmetic results. Thus, the ORL is a rigid and restrictive internal connected structure, and the ORL-assisted technique decreases the defect size and reconstructs vertical force balance. The LOT and the LBT are strong and safe enough as new fixation choices for lower eyelid suspension.
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