鼻唇沟还原式手术设计的解剖学基础

The applied anatomy on the plastic operation in nasolabial fold area

目的为鼻唇沟区域的还原式美容手术设计提供形态学基础。方法采用经福尔马林防腐固定、红色乳胶动脉灌注的成人女性尸头10例,应用显微手术器械,沿着颞部发际线、耳屏内侧、下颌角下颌骨体边缘连线作切口,分层显微解剖。结果①在提上唇鼻翼肌上外缘和眶下缘之间皮下肌腱膜系统(SMAS)下可见一自外上向内下的组织疏松间隙,可作为提紧软组织,改善鼻唇沟的分离腔隙;②起自颧骨与上颌骨交界处骨膜,终止于颊部的SMAS筋膜和皮肤上的韧带—颊上颌韧带,该韧带上部脂肪组织较多,韧带以下脂肪较少,是鼻唇沟皱襞形成的解剖要素。结论鼻唇沟的加深与衰老所致皮肤、脂肪、韧带松弛和肌肉运动、重力等多种因素密切相关,分析不同个体的鼻唇沟形态学结构特点,采用符合解剖结构和运动特点的术式矫正,可以达到良好的预期效果。

Objective To provide morphologic data for plastic operating in nasolabial fold area.Methods：10 formalin fixed adult female head specimens perfused with red latex were used in this study.Microdissection was performed on the specimens along the incision from the tempus＇s hairline and the medial side of antilobium to the edge of the mandible.Results ①Under the subcutaneous musculoaponeurotic system（SMAS）between the outer edge of levator labii superioris alaeque nasi＇s and infraorbital margin,a loose tissue space directed from the laterosuperior part to the medoinferior part can be taken as the operation space for tighting soft tissues and molding nasolabial fold.② Cheek-upper mandible ligament,stretching from the periosteum at the junction of the maxilla and the cheek bone,to the SMAS fascia and the cheek skin,with the more fat tissue at the upper part and the less at the lower part,was the key anatomic element for forming nasolabial fold.Conclusions The appearance of nasolabial fold is closely related to various factors such as the laxity of ageing skin,fat and ligaments,frequent muscle contraction,the gravity and the maxillary hypoplasia etc.Morphological analysis of different structural characteristics of individual nasolabial fold,consistent with anatomical,physiological structure and motion characteristics of surgical correction,can be expected to achieve good results.