Codère F, Tucker N A, Renaldi B
Oculoplastics Unit, McGill University, Montreal, Canada.
Ophthalmology. 1995 Dec;102(12):2016-9. doi: 10.1016/s0161-6420(95)30761-0.
The current understanding of the anatomy of Whitnall ligament does not explain its functional role in eyelid movement. This anatomic study was designed to determine the exact relation of Whitnall ligament to the levator muscle and aponeurosis.
The anatomy of the eyelid was examined by surgical dissection of 20 eyelids undergoing Müllerectomy via a conjunctival approach, anatomic dissection of 20 fresh cadaver orbits, and histologic correlation in four fresh specimens.
Whitnall ligament is a sleeve of fibrous tissue with both a superior and inferior component which join medially and laterally before inserting onto the bony orbit.
The authors postulate that this sleeve acts as a mobile fulcrum straddling the underneath surface of the levator aponeurosis and functions to convert the anterior-posterior vector force of the levator to a superior-inferior direction during eyelid movement. This model proposes that when the levator is relaxed, Whitnall sleeve hangs down, allowing the lid to close. When the muscle contracts, the sleeve along with the levator aponeurosis is lifted superiorly in the orbit, enhancing the lifting effect of levator muscle contraction in eyelid elevation.
目前对惠特纳尔韧带解剖结构的认识尚无法解释其在眼睑运动中的功能作用。本解剖学研究旨在确定惠特纳尔韧带与提上睑肌及腱膜的确切关系。
通过对20例经结膜入路行米勒肌切除术的眼睑进行手术解剖、对20个新鲜尸体眼眶进行解剖以及对4个新鲜标本进行组织学关联研究，来检查眼睑的解剖结构。
惠特纳尔韧带是一个纤维组织套，有上、下两部分，在插入眶骨之前，于内侧和外侧相连。
作者推测，这个纤维组织套作为一个活动支点横跨提上睑肌腱膜的下表面，在眼睑运动过程中起到将提上睑肌的前后向矢量力转换为上下向力的作用。该模型表明，当提上睑肌松弛时，惠特纳尔纤维组织套下垂，使眼睑闭合。当肌肉收缩时，纤维组织套与提上睑肌腱膜一起在眼眶内向上提升，增强提上睑肌收缩在眼睑上提过程中的提升效果。
