面部韧带的解剖学研究

Study on the anatomy of superficial musculo aponeurotic system related to rhytidectomy

本文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了面部韧带。定性定量观察了6个面部韧带。证实国外报道的颧弓韧带、下颌骨韧带、颈阔肌-皮肤前韧带和颈阔肌-耳韧带的存在。本文描述的颈阔肌-耳韧带与国外研究结果有较大的差别。首次指出面部存在着颈阔肌悬韧带和SMAS-颧颊部韧带两个新发现的结构。阐述了面部韧带的作用以及临床应用要点。

The superficial musculo-apoheurotic system(SMAS) has been disputed in controversy. The goal of our study was to further clarify the existance of the SMAS. With an operating microscope, we dissected 10 fresh cadaver heads (20 hemiheads) exposing the SMAS. SMAS and its relationship to other anatomic structures, particularly parotid fascia and facial nerve were identified. Full-thickness sections were obtained for routine histologic studies. Data revealed the presence of the SMAS as a distinct fibromuscular layer composed of: (1)muscular regions; (2)aponeurotic regions; (3)mixture regions. The muscular regions, connecting the boundary of the aponeurotic regions, are composed of superficial mimic muscles. The aponeurotic regions are aponeuroses containing intrinsic muscles, including three parts. A role of the 'centre aponeurosis' played in the SMAS, acts not only as an amplifier and a distributor but also as a 'preparing device' of the contractions of the facial muscles.