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目的:为临床应用额肌加额肌腱膜组织瓣悬吊上睑、治疗重症上睑下垂症,提供解剖学基础。方法:在手术显微镜下,解剖观测30侧额肌腱膜的起止点、宽、厚度及腱膜与面神经颞支、眶上神经的关系。用组织切片光镜下观察腱膜的组织结构。结果:额肌腱膜起点距眶上缘的外、中、内1/3上方的距离分别是0.6cm、0.9cm、0.6cm。腱膜呈半月形,厚0.05cm,宽3.4cm,外侧缘距面神经颞支1.9cm。腱膜的组织构成为致密结缔组织,成束排列的胶原纤维方向与额肌纤维的方向一致。结论:应用额肌腱膜和额肌组织瓣悬吊上睑,可最大程度减少手术固定部位撕裂,提高手术效果。
OBJECTIVE: To provide anatomical basis for the clinical application of frontal muscle plus forearm membrane flap for upper eyelid treatment for severe ptosis. Methods: Under the operation microscope, the thickness, thickness and the relationship between the aponeurosis and the temporal branch of the facial nerve and supraorbital nerve were observed anatomically. The tissue of the aponeurosis was observed with tissue sections under light microscope. Results: The frontal forearm aponeurosis from the supraorbital margin of the outer, middle and inner 1/3 of the distance are 0.6cm, 0.9cm, 0.6cm. Aponeurosis was semilunar, thickness 0.05cm, width 3.4cm, lateral margin of the temporal branch of the temporal branch 1.9cm. The tissue of the aponeurosis is composed of dense connective tissue. The bundles of collagen fibers are arranged in the same direction as the frontal muscle fibers. Conclusion: The amount of the frontal muscle tendon and frontal muscle flap suspension of the upper eyelid, can minimize the operation of the fixed parts of the tear, improve surgical results.