Ghavami Ashkan, Pessa Joel E, Janis Jeffrey, Khosla Rohit, Reece Edward M, Rohrich Rod J
Dallas, Texas From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
Plast Reconstr Surg. 2008 Mar;121(3):994-1001. doi: 10.1097/01.prs.0000299941.62645.4e.
There exists some ambiguity regarding the exact anatomical limits of the orbicularis retaining ligament, particularly its medial boundary in both the superior and inferior orbits. Precise understanding of this anatomy is necessary during periorbital rejuvenation.
Sixteen fresh hemifacial cadaver dissections were performed in the anatomy laboratory to evaluate the anatomy of the orbicularis retaining ligament. Dissection was assisted by magnification with loupes and the operating microscope.
A ligamentous system was found that arises from the inferior and superior orbital rim that is truly periorbital. This ligament spans the entire circumference of the orbit from the medial to the lateral canthus. There exists a fusion line between the orbital septum and the orbicularis retaining ligament in the superior orbit, indistinguishable from the arcus marginalis of the inferior orbital rim. Laterally, the orbicularis retaining ligament contributes to the lateral canthal ligament, consistent with previous studies. No contribution to the medial canthus was identified in this study.
The orbicularis retaining ligament is a true, circumferential "periorbital" structure. This ligament may serve two purposes: (1) to act as a fixation point for the orbicularis muscle of the upper and lower eyelids and (2) to protect the ocular globe. With techniques of periorbital injection with fillers and botulinum toxin becoming ever more popular, understanding the orbicularis retaining ligament's function as a partitioning membrane is mandatory for avoiding ocular complications. As a support structure, examples are shown of how manipulation of this ligament may benefit canthopexy, septal reset, and brow-lift procedures as described by Hoxworth.
眼轮匝肌保留韧带的确切解剖界限存在一些模糊之处，尤其是其在上、下眼眶中的内侧边界。在眶周年轻化手术中，精确了解该解剖结构是必要的。
在解剖实验室对16例新鲜半侧面部尸体进行解剖，以评估眼轮匝肌保留韧带的解剖结构。解剖过程中使用放大镜和手术显微镜辅助。
发现一个真正眶周的韧带系统，它起源于眶上缘和眶下缘。该韧带从内侧眦到外侧眦跨越眼眶的整个周长。在上眼眶中，眶隔与眼轮匝肌保留韧带之间存在一条融合线，与眶下缘的眶缘弓难以区分。在外侧，眼轮匝肌保留韧带构成外侧眦韧带，与先前的研究一致。本研究未发现其对内侧眦有贡献。
眼轮匝肌保留韧带是一个真正的、环绕眼眶的“眶周”结构。该韧带可能有两个作用：（1）作为上、下眼睑眼轮匝肌的固定点；（2）保护眼球。随着眶周填充剂注射和肉毒杆菌毒素技术越来越流行，了解眼轮匝肌保留韧带作为分隔膜的功能对于避免眼部并发症至关重要。作为一种支撑结构，文中展示了如霍克斯沃思所描述的，对该韧带的操作如何可能有益于眦固定术、眶隔复位术和提眉手术的实例。
