Galatoire O, Touitou V, Heran F, Amar N, Jacomet P V, Gheck L, Berete-Coulibaly R, Benchekroun S, Morax S
Department of Ophthalmology and Reconstructive Surgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France.
Orbit. 2007 Sep;26(3):165-71. doi: 10.1080/01676830701558091.
The position and appearance of the upper eyelid crease is one of the challenges in eyelid surgery. The aim of this study was to compare the clinical appearance of the upper eyelid crease with its anatomy, including the position of the levator, the septum, and the orbital fat as determined by Magnetic Resonance Imaging (MRI).
Oculoplastic examination was performed in normal volunteers of the same age with different appearances of the upper eyelid. MRI (Intera 1.5 T, Philips, the Netherlands) was carried out with both head and surface coils in all volunteers. Subjects were asked to keep their eyes closed during the whole procedure, thus reducing artefacts due to eyeball movements. The protocol lasted 8 minutes and included a multiplanar scout to obtain T1-weighted 3D-images. Thin sagittal T2 sequences were obtained along the plane of the optic nerve and focused on both orbits, allowing a precise analysis of the orbital content and eyelid anatomy.
Six volunteers were included in this prospective study, three of Caucasian origin and three of North African, Central African and Asian origin, respectively. We distinguished two appearances of the crease: in some cases, the superior eyelid sulcus was convex, while in other cases it was concave. The superior eyelid fold was either high or low. Two Caucasian subjects had a deep, concave superior eyelid sulcus with a high crease. This crease appearance was correlated with a short concave appearance of the septum, which pulled back the pre-aponeurotic fat. The non-Caucasian volunteers all had a convex superior eyelid sulcus. The orbital septum insertion was low on the levator aponeurosis, and the orbital fat pad drooped onto the levator muscle, accounting for the convexity of the upper eyelid sulcus. A skin fold was formed by redundant skin over the crease.
MRI provides excellent images and allows a good analysis of the upper eyelid components. It permits a detailed analysis of the architecture for a better understanding of its appearance and of the crease position, although further investigation with a larger number of volunteers is required.
上睑皱襞的位置和外观是眼睑手术中的挑战之一。本研究的目的是比较上睑皱襞的临床外观与其解剖结构，包括提上睑肌、眶隔和眼眶脂肪的位置，这些通过磁共振成像（MRI）来确定。
对年龄相同但上睑外观不同的正常志愿者进行眼部整形检查。所有志愿者均使用头部和表面线圈进行MRI检查（Intera 1.5 T，飞利浦，荷兰）。在整个检查过程中，要求受试者闭上眼睛，从而减少眼球运动产生的伪影。检查方案持续8分钟，包括多平面定位扫描以获取T1加权3D图像。沿视神经平面获取薄的矢状面T2序列，并聚焦于双侧眼眶，以便精确分析眼眶内容物和眼睑解剖结构。
本前瞻性研究纳入了6名志愿者，分别为3名白种人、3名来自北非、中非和亚洲的志愿者。我们区分出两种皱襞外观：在某些情况下，上睑沟是凸的，而在其他情况下是凹的。上睑皱襞要么高要么低。两名白种人受试者有深的、凹的上睑沟且皱襞高。这种皱襞外观与眶隔短的凹形外观相关，眶隔将眶隔前脂肪向后牵拉。非白种人志愿者的上睑沟均为凸形。眶隔在上睑提肌腱膜上的附着较低，眶脂肪垫垂落在提上睑肌上，这导致了上睑沟的凸形。皱襞上方的多余皮肤形成了皮肤皱襞。
MRI提供了出色的图像，能够对上睑各组成部分进行良好的分析。它允许对结构进行详细分析，以便更好地理解其外观和皱襞位置，尽管还需要对更多志愿者进行进一步研究。
