【 文献重点摘要 】
 

Background: The exact anatomical cause of the tear trough remains undefined. This study was performed to identify the anatomical basis for the tear trough deformity.

Methods: Forty-eight cadaveric hemifaces were dissected. With the skin over the midcheek intact, the tear trough area was approached through the preseptal space above and prezygomatic space below. The origins of the palpebral and orbital parts of the orbicularis oculi (which sandwich the ligament) were released meticulously from the maxilla, and the tear trough ligament was isolated intact and in continuity with the orbicularis retaining ligament. The ligaments were submitted for histologic analysis.

Results: A true osteocutaneous ligament called the tear trough ligament was consistently found on the maxilla, between the palpebral and orbital parts of the orbicularis oculi, cephalad and caudal to the ligament, respectively. It commences medially, at the level of the insertion of the medial canthal tendon, just inferior to the anterior lacrimal crest, to approximately the medial-pupil line, where it continues laterally as the bilayered orbicularis retaining ligament. Histologic evaluation confirmed the ligamentous nature of the tear trough ligament, with features identical to those of the zygomatic ligament.

Conclusions: This study clearly demonstrated that the prominence of the tear trough has its anatomical origin in the tear trough ligament. This ligament has not been isolated previously using standard dissection, but using the approach described, the tear trough ligament is clearly seen. The description of this ligament sheds new light on considerations when designing procedures to address the tear trough and the midcheek.

背景：泪沟的确切解剖原因仍未确定。本研究旨在确定泪沟畸形的解剖学基础。

方法：解剖48具尸体半面。在面颊中部皮肤完整的情况下，泪沟区域通过上方的前间隙和下方的前间隙进入。眼轮匝肌的眼睑和眼眶部分(夹住韧带)的起点从上颌骨被小心地分离出来，泪沟韧带被完整地分离出来，并与眼轮匝肌保持韧带保持连续性。韧带被提交进行组织学分析。

结果：一个真正的骨皮韧带，称为泪沟韧带，始终存在于上颌骨上，分别位于眼轮匝肌的眼睑和眼眶部分之间，韧带的头侧和尾侧。它从内侧开始，在内眦肌腱的插入水平处，就在前泪腺嵴的下方，大约到内侧瞳孔线，在那里它作为双层眼轮匝肌保持韧带横向继续。组织学评估证实了泪沟韧带的韧带性质，其特征与颧韧带相同。

结论：本研究清楚地证明了泪沟的突出是起源于泪沟韧带。这个韧带以前没有用标准解剖法分离过，但是用描述的方法，泪沟韧带清晰可见。对这种韧带的描述为设计处理泪沟和面颊中部的手术时的考虑提供了新的思路。