面部表浅肌肉腱膜系统的解剖学研究

Facial ligaments study: Its anatomy in relation to rhytidectomy

采用手术显微镜下解剖、光镜组织切片观察结合外科手术方法研究表浅肌肉腱膜系统(SMAS)。SMAS是上至颅顶额枕部、下至颈部的连续解剖学结构。主要与国外报道不同的是:它连接于浅层表情肌周边部而不跨越肌浅面;SMAS有肌性区域、腱膜性区域和混合性区域之分,提出腱膜性区域是SMAS的“中间腱”假说;第一次定义了SMAS这一解剖结构。

Twenty-two hemifaces of fresh human cadaver were studied, through an operating microscope, and histologic examination to identify the facial ligaments. Data revealed: there were six ligaments demonstrated: zygomatic ligament(ZL), mandibular ligament(ML), suspensory platysma ligament(SPL), platysma-auricular ligament(P-AL), SMAS-malar ligament(SMAS-ML)and anterior platysma-cutaneous ligament(AP-CL). Except the ML and the AP-CL, they are all in the neighbourhood of vessels and nerves, and hence important for dissecting and protecting vessels and nerves as well as their retaining the skin or the ptalysma-SMAS. On the other hand, this adds the difficulty in treating the ligaments.The findings under microscope were:: ①The SPL consists of fibrous fascia, and the others are bands of dense connective tissue; ②they are not perpendicular at all from the originating part to the attaching one. The SMAS-ML has been described qualitatively and quantitatively for the first time. The SPL is the new structure of the retaining platysma discovered.