눈꺼풀의 해부학

초록

144차 영동집담회 계획표 ▣ 언 제 : 2001년 11월 24일 오전 8시 ▣ 연 자 : 황 건 (인하의대 성형외과부교수) ▣ 제 목 : 눈꺼풀의 해부학 (Anatomy of eyelids); 책에는 나와있지 않은 내용 ① 눈꺼풀올림근널힘줄과 눈사이막 (Levator Aponeurosis vs orbital septum) ② 아래눈꺼풀의 눈꺼풀판앞 지방칸 (Pretarsal fat compartment in lower eyelid) ③ 아래눈둘레근의 신경지배 (Innervation of Orbicularis oculi m. in lower eyelid) ④ 눈꺼풀올림근에 분포하는 눈돌림신경의 변이 : 눈꺼풀 수술후의 일시적 눈꺼풀 처짐과 관련하여 (Patterns of oculomotor nerve distribution to the levator palpebral muscle and correlation to temporary ptosis after blepharoplasty) <Abstracts> ① HWANG KUN, D.J.Kim, R.S.Chung, S.I.Lee, Y.Hiraga. British Journal of Plastic Surgery : SCI, Vol 51, No 8. 594-598. Knowledge of the detailed anatomy of the orbital septum and levator aponeurosis is mandatory for oculoplastic surgeons. Examination of the histological detail of these two orbital structures is missing in the medical literature. This article elucidates the relationship based on cadaber and surgical dissections. The anatomical relationships of the orbital septum and levator aponeurosis has been studied in 40 eyelids subjected to blepharoplasty and corrective ptosis surgery by dissection in 10 cadavers and in histological sections. The orbital septum originates from the arcus marginalis of the frontal bone and consists of two layers. The whitish outer(superficial) layer, containing vertically running vessels, descends just inside the orbicularis oculi muscle to interdigitate with the levator aponeurosis with loose initially, then reflects at the levator aponeurosis and continues posteriorly with the levator sheath. We reconfirmed Whitnall's original description that the levator sheath thickens to form the superior transverse ligament runs continuously inferorly anterior to the levator aponeurosis and forms the inner layer of the orbital septum. Th