The clinical analysis of orbital septum fat replacement combined with orbicularis oculi muscle flap transposition in correction of tear trough deformity
10.3760/cma.j.cn114453-20210808-00336
- VernacularTitle:眶隔脂肪重置联合眼轮匝肌瓣转位矫正泪沟畸形疗效分析
- Author:
Yu CHEN
1
;
Yide XIE
Author Information
1. 福建医科大学附属协和医院整形外科与再生医学科，福州 350000
- Keywords:
Blepharoplasty;
Tear trough deformity;
Orbicularis oculi muscle flap;
Orbital septum fat
- From:
Chinese Journal of Plastic Surgery
2022;38(9):986-992
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of orbital septal fat replacement combined with orbicularis oculi muscle flap transposition in correction of tear trough deformity.Methods:The clinical data of patients with tear trough deformity underwent surgical correction admitted to Fujian Medical University Union Hospital from January 2009 to January 2020 were retrospectively analyzed. According to the surgical methods, they were divided into the combined group (orbital septal fat replacement combined with orbicularis oculi muscle flap transpose) and the simple group (orbital septal fat replacement). Surgical methods: using percutaneous approach, the orbital septum fat was separated and replaced under the orbicularis oculi muscle to fill the tear trough deformity, and the orbicularis oculi muscle flap with the transfer pedicle on the medial side was added to fill the medial tear trough deformity in the combined group. Before and 6 months after surgery, Hirmand scale was used to rate the tear trough deformity(grade Ⅰ, Ⅱ, Ⅲ, severity is increasing from medial to lateral), and the lower eyelid without obvious tear trough deformity was rated as grade 0. The improvement rate and the complete improvement rate were calculated in the two groups. The related complications were followed up within 1 month after operation. Chi-square test or Fisher’s exact test was used to compare Hirmand improvement rate at all levels and complete improvement rate between groups. P< 0.05 was considered statistically significant. Results:A total of 175 patients (350 lower eyelids) were enrolled. There were 104 patients (208 lower eyelids) in the combined group [16 males and 88 females, aged (34.3±8.3) years old], including 47 cases of Hirmand grade Ⅰ, 54 cases of Hirmand grade Ⅱ and 107 cases of Hirmand grade Ⅲ before operation. There were 71 patients (142 lower eyelids) in simple group [7 males and 64 females, aged (33.2±8.6) years old], including 24 cases of Hirmand grade Ⅰ, 32 cases of Hirmand grade Ⅱ and 86 cases of Hirmand grade Ⅲ before operation. At 6 months after operation, the improvement rate of grade Ⅰ cases in the combined group was 91.5% (43/47), which was higher than that in the simple group (54.2%, 13/24) ( P<0.01), while there was no significant difference in the improvement rate of grade Ⅱ and Ⅲ cases between the two groups ( P>0.05). The complete improvement rates of grade Ⅰ, Ⅱ and Ⅲ cases in the combined group were 91.5% (43/47), 77.8% (42/54) and 72.0% (77/107), respectively, which were higher than those in the simple group [54.2% (13/24), 25.0% (8/32) and 24.4% (21/86)], and the differences were statistically significant (all P<0.01). Postoperative complications included ectropion, hematoma, ecchymosis, and local edema for more than 2 weeks. There was no significant difference in the incidence of complications between the two groups ( P>0.05). Conclusions:Orbital septal fat replacement combined with orbicularis oculi muscle flap transposition can improve all levels of tear trough deformity, and the improvement effect of medial lacrimal groove depression is significantly better than that of orbital septal fat replacement alone.
