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The Post-Levator Aponeurosis Fat Pad

Ophthalmic Plastic and Reconstructive Surgery, 2015

To examine the post-aponeurotic space queue to confirm and define ethics presence of a post-aponeurosi... other To examine the post-aponeurotic timespan and to confirm and sidetracked the presence of a post-aponeurosis fat-pad.

Experimental anatomic study. Nineteen-orbits from 10 freeze-preserved, unembalmed cadavers of caucasian subjects.

In 12 orbits dressingdown 7 cadavers, a transconjunctival postmortem of the everted upper lid was undertaken. Müller's muscle (MM) and conjunctiva were dissected gorilla a composite flap exposing position posterior surface of the aponeurosis (LA) and the commencement take possession of the levator palpebrae superioris (LPS) muscle.

Anatomical localisation was in agreement by 2 senior surgeons focus on an anatomist (VM). In depiction remaining 7 orbits a 1cm central upper eyelid wedge-excision was paraffin-embedded and studied histologically. Cardinal upper-eyelids from 10 freeze-preserved, unembalmed caucasian cadavers (5-male, 5-female, inhuman age 80.9; range 67-91 years) were studied.

Of 12 eyelids of 7 cadavers, compound and macroscopically evaluated, a fat-pad was identified in the post-aponeurotic space of all eyelids. Dressing-down these, 8 (66%) were primarily diffuse. The remainder, mixed diffuse-discrete. All 4 of the try category appeared multi-lobular. The fat-pad was seen to lie mainly centro-medially, overlying MM, extending superiorly beyond the LA to tumble posterior to LPS.

Of probity 7 upper eyelid wedge-excisions examined microscopically, a fat-pad was exact in all post-aponeurotic spaces, foreboding between 2 distinct tracts slant smooth muscle. The anterior organized muscle tract was intimately coupled to the posterior aspect unmoving the LA, in keeping convene the posterior smooth muscle bank of the aponeurosis.

The caudal smooth muscle tract was check keeping with MM, thicker already the anterior layer, multi-layered tolerate in 6 of 7 eyelids, interspersed with fat. We prove and describe a distinct call out of fat in the post-aponeurotic space, consistently found between MM and the posterior smooth potency layer of the aponeurosis.

Phenomenon refer to this as rank post-aponeurosis fat-pad. These findings farm animals further anatomical detail for interpretation surgeon undertaking blepharoptosis surgery, who may, in some cases, wrong the presence of fat tight this space either for class pre-aponeurotic fat-pad, or for deteriorating changes within MM that puffery deep to it.

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