Iwanami Masaaki, Tsurukiri Kazumi
Yokohama and Tokyo, Japan From the Shin-Yokohama Keisei Clinic and the Tsurukiri Keisei-Hifuka Clinic.
Plast Reconstr Surg. 2007 Jun;119(7):2061-2071. doi: 10.1097/01.prs.0000260617.03837.2e.
Understanding the anatomy of the lower eyelid, including the effect of aging, assists in blepharoplasty.
After celloidin was embedded, 30-mum-thick serial sagittal sections from the medial to the lateral canthus were prepared from two Japanese left lower eyelid specimens obtained from a young cadaver and an old cadaver. A comparative study was then performed.
The orbicularis oculi muscle was divided into three portions. Each muscular portion was transformed by aging. The fascia group that maintained the orbicularis oculi muscle was observed. Particularly, the fasciae in the upper and lower portions were termed the "upper fascia" and "lower fascia," respectively. These fasciae were generically referred to as "suborbicularis retaining fasciae." The suborbicularis retaining fasciae relaxed with aging. Fat tissue was observed in front of the orbital septum and was termed "preseptal adipose tissue." This area was most sensitive to deep pressure, because the retaining fascia hardly exists here; it almost disappears with aging. The retinacula cutis connected the orbicularis oculi muscle and the skin in parallel; their palisade structure was not clear in the aged specimen. In both specimens, the tarsal muscle did not unite with the tarsus, and the muscle fiber was enlarged at the lateral border of the tarsus.
Lower eyelid aging changes were involved in the transformation of the three parts of the orbicularis oculi muscle, the relaxation of the suborbicularis retaining fasciae, the disappearance of the preseptal adipose tissue area due to orbital fat herniation, and the indistinctness of the palisade structure of the retinacula cutis.
了解下睑的解剖结构,包括衰老的影响,有助于进行眼睑成形术。
用火棉胶包埋后,从一具年轻尸体和一具老年尸体获取的两例日本左下睑标本制备从内眦到外眦的30微米厚连续矢状切片。然后进行比较研究。
眼轮匝肌分为三部分。每个肌肉部分都会因衰老而发生变化。观察到维持眼轮匝肌的筋膜组。特别是,上部和下部的筋膜分别称为“上筋膜”和“下筋膜”。这些筋膜统称为“眼轮匝肌下保留筋膜”。眼轮匝肌下保留筋膜会随着衰老而松弛。在眶隔前方观察到脂肪组织,称为“眶隔前脂肪组织”。该区域对深压最为敏感,因为此处几乎不存在保留筋膜;随着衰老它几乎消失。皮肤支持带将眼轮匝肌和皮肤平行连接;在老年标本中它们的栅栏状结构不清晰。在两个标本中,睑板肌均未与睑板相连,且肌纤维在睑板外侧缘增粗。
下睑衰老变化涉及眼轮匝肌三部分的转变、眼轮匝肌下保留筋膜的松弛、眶隔前脂肪组织区域因眶脂肪疝出而消失以及皮肤支持带栅栏状结构不清晰。