RU2578364C1 - Method for correction of lachrymal depth of furrow - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention is intended for improving skin condition, as well as for deficient volume of soft tissues in the area of lachrymonasal furrow. Selected safe access point for needle guide cannula for this marking is applied in the form of two lines, one of which passes through the medial angle of eye and the angle of the lower jaw, the second connects the wing of nose with the tragus auricle. At the point of intersection of said two lines at the top of bilge tuberosity finally determined safe access point, and marked this point. Marking is zones with deficit of volume of soft tissues within a lachrymal furrow and in the direction of said zones are applied marking assumed vectors passing through the cannula diverging in the form of beams of safe access point. Injection of hyaluronic acid is carried out through the selected safe access point linearly retrograde equipment in the direction of vectors passing through the cannula of the preparation volume of not more than 0.1 ml per one vector.

EFFECT: method enables reducing a risk of developing side effects of injections by determining safe access point for the guide needle cannula, as well as more effective correction of lachrymal depth of furrow.

1 cl, 5 dwg, 1 ex

Description

The invention relates to medicine, in particular cosmetology, dermatology, plastic surgery, and is intended to improve the condition of the skin, as well as to fill the deficit in the volume of soft tissues in the lower eyelid.

The area around the eyes is one of the most significant in terms of visual perception and assessment of age-related changes. For a long time, only the lateral region, characterized by the presence of facial wrinkles (“crow's feet”), underwent aesthetic correction in the periorbital region. However, to date, the medial periorbital region, in particular the projection zone of the lacrimal groove (linear deepening on the lacrimal bone and on the nasal surface of the upper jaw), is also subject to correction by cosmetologists. This area, in particular the medial angle of the eye, the lower orbital region, is an anatomically dangerous area, characterized by the passage of a number of important vascular and neurovascular pathways. In particular, the route of the angular artery and vein has a projection that either coincides with the projection of the lacrimal groove, or is located more caudally (lower) by about 0.3 cm. In addition, one of the branches of the infraorbital neurovascular bundle, leaving the level of deep fat packets and heading more superficially, can also coincide in its projection with the projection of the lacrimal groove.

It is known to use a needle with a diameter of 27G and a length of 1.4 cm to work in the medial periorbital area (Medical technology "Contour plastic implants for intradermal use based on hyaluronic acid" // Clinical and experimental dermatocosmetology, No. 3, 2007). In practice, when injecting with a needle, there is a high risk of developing a number of side effects in this area, such as the formation of hyperemia, hematomas, and swelling. In addition, a serious complication can occur - embolization of an artery or vein (angular, infraorbital) due to the filler entering the lumen of the vessel. The described side effects and complications are associated primarily with the technical component of the procedure, that is, with the use of a needle.

At present, cosmetologists also use cannulas for injection methods in addition to needles (blunt needles up to 5-6 cm long with an opening on the lateral distal surface). Injection using a cannula reduces the risk of all of the side effects and complications described above. Known, for example, the correction of the lacrimal groove with hyaluronic acid using a cannula (http://www.nedug.ru). This method is adopted as a prototype.

The disadvantage of this method is the great risk of developing adverse events after injection due to the lack of clear criteria for choosing the primary puncture point (access point) for the cannula conductor needle.

The objective of the invention is to reduce the risk of adverse events by determining a safe access point for the needle-guide cannula.

The technical result of the invention is to increase the efficiency of correction of the depth of the lacrimal groove.

The problem is solved, and the technical result is achieved by the method of correcting the depth of the lacrimal groove, which consists in the injection of a drug based on hyaluronic acid using a cannula. In contrast to the prototype, a safe access point for the cannula conductor needle is chosen, for which markings are applied in the form of two lines, one of which passes through the medial angle of the eye and the angle of the lower jaw, the second connects the wing of the nose with the tragus of the auricle, and at the intersection of these of two lines on the top of the zygomatic tubercle finally determine the safe access point by palpation and mark this point, after which mark areas with a deficit in the volume of soft tissues in the area of the lacrimal groove and in the direction of these areas Put the marking of the proposed cannula passage vectors diverging in the form of rays from a safe access point, and then hyaluronic acid is injected through the selected safe access point using linear retrograde technique in the direction of the cannula passage vectors, the drug volume is not more than 0.1 ml per vector.

The technical result is due to the following. A safe access point for the needle-guide of the cannula is at the intersection of two lines that divide the buccal region into 4 squares. Of these, 1, 2 squares are richest in collaterals going from the facial artery and vein to superficially located soft tissues. The projection of 3 squares is characterized by the passage of the transverse artery and vein, the excretory duct of the parotid salivary gland, and the buccal branch of the facial nerve. Square 4 repeats the projection of the zygomatic tubercle, which is topographically not characterized by the presence of large arteries of vessels and nerves. This leads to the fact that when injected at a selected point, large arteries and veins are not injured. Thus, the risk of complications from injection is significantly reduced.

The invention is illustrated by drawings, which show:

in FIG. 1 - patient's face before the procedure;

in FIG. 2 - line marking for selecting an access point for a needle-guide cannula;

in FIG. 3 - labeling of areas with a deficit in the volume of soft tissues in the area of the lacrimal groove;

in FIG. 4 - marking of the estimated cannula passage vectors;

in FIG. 5 is a view of the patient’s face after the procedure.

The method is as follows.

First, a safe access point is selected for the cannula guide needle, for which markings are applied in the form of two lines (Fig. 2), one of which passes through the medial corner of the eye and the angle of the lower jaw, the second connects the wing of the nose with the tragus of the auricle, and finally the point access determined palpation on top of the zygomatic tubercle at the intersection of these two lines. Palpation of the top of the zygomatic tubercle is an important diagnostic feature that gives the doctor additional confidence in the correct access point. Mark this point. After that, marking of areas with a deficit in the volume of soft tissues (Fig. 3) in the area of the lacrimal groove is made and markings of the estimated cannula passage vectors (Fig. 4) are applied. As a rule, no more than two vectors are required. Then, hyaluronic acid is injected through a selected safe point in the direction of the cannula passage vectors by linear retrograde technique in a filler volume of not more than 0.1 ml per vector.

A method for correcting the depth of the lacrimal groove is illustrated by an example of a specific implementation.

The patient is 48 years old.

At the appointment with a cosmetologist, a visualization of the lacrimal groove was diagnosed (Fig. 1). It is recommended that injection soft tissue augmentation of this area be performed using a filler based on hyaluronic acid (HA).

First, lines were marked (Fig. 2) to select a safe injection point: from the inner corner of the eye to the corner of the lower jaw and from the wing of the nose to the tragus of the auricle. The intersection point of these lines is the access point for the cannula guide needle. In this case, the access point is finally determined by palpation on top of the zygomatic tubercle. The diameter of the cannula, adapted for diameter (25G) for HA-based fillers for the correction of the lacrimal groove, is 5-6 cm. After marking the access point, a zone with a deficit in the volume of soft tissues was marked (Fig. 3) in the region of the lacrimal groove and the direction of two cannula passage vectors (Fig. 4). After marking the vectors, the HA was injected with a linear retrograde technique through a selected point in the direction of the cannula passage vectors, the filler volume was 0.1 ml per vector. The final clinical result was evaluated after 2 weeks. There was a replenishment of the deficit of soft tissues in the region of the lacrimal groove, the absence of side effects (Fig. 5).

Thus, the application of the invention allows to reduce the risk of adverse events by determining a safe access point for the needle-guide cannula, as well as to increase the efficiency of correction of the depth of the lacrimal groove.

Claims (1)

A method for correcting the depth of the lacrimal groove, which consists in injecting a preparation based on hyaluronic acid using a cannula, characterized in that a safe access point for the cannula guide needle is selected, for which markings are applied in the form of two lines, one of which passes through the medial corner of the eye and the angle of the lower jaw, the second connects the wing of the nose with the tragus of the auricle, and at the intersection of these two lines on the top of the zygomatic tubercle, a safe access point is determined by palpation and mar this point, then mark areas with a deficit in the volume of soft tissues in the area of the lacrimal groove and mark in the direction of these areas mark the estimated vectors of passage of the cannula diverging in the form of rays from a safe access point, after which hyaluronic acid is injected through the selected safe access point by linear retrograde technique in the direction of cannula passage vectors with a drug volume of not more than 0.1 ml per one vector.

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