关键词：鼻唇沟；鼻唇沟除皱术
【摘要】 目的 提高鼻唇沟除皱手术效果。方法 对10例成人尸体20侧鼻唇沟局部解剖及组织切片研究，发现鼻唇沟形成机理，改进手术方法。结果 提出表情肌长期反复运动使得皮肤—皮下组织与SMAS—表情肌之间产生剪切应力及向下相对位移，鼻唇沟部位上下两种质地、结构密度相差较大的组织之间产生相对运动，形成了鼻唇沟及鼻唇沟脊。采用新手术方法为13例患者进行鼻唇沟除皱手术，获得较好的近期及远期效果。结论 鼻唇沟除皱手术须在SMAS表面、皮下组织深面正确层次中进行，切断SMAS与表情肌及上唇的联系，解剖复位颧颊部组织，重建颧弓韧带。
Study of the local anatomyand clinical practice about rhytidectomy of nasolabial fold
YUANG Zhiwei* , YANG Peiying, FENG Guangzhen. Department of Plastic Surgery， The General Hospital of the People's Armed Forces ofChina, Beijing, 100039
【 Abstract 】 Objective A technique is introduced to improve the operative resultof rhytidetomy of the nasolabial fold. Methods Regional anatomy was studied on 10 adult cadavars togetherwith histological examinations of tissue sections to investigate the formation mechanismof the nasolabial fold. 13 patients were operated on using a new technique of nasolabialfold rhytidectomy.Results Prolonged and repeated movements of the facial mimetic musclesproduce a shearing force between the skin-subcutaneous tissue and the SMAS-mimeticmuscles, causing relative motion of adjacent tissues with different structure at the siteof the nasolabial fold, thus producing the nasolabial fold. In clinical application of thefinding, the nasolabial folds of 13 patients were corrected with remarkable early andlong-term results postoperatively. Conclusion The operation should be performed between SMAS and thesubcutaneous tissue. SMAS should be incised along the zygomatic major muscle. Thefibro-fatty zygomatic pad should be replaced anatomically and the zygomatic ligament bereconstructed.
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