注射美容相关的颞部解剖学研究

Anatomical study of temporal region for cosmetic injections

目的阐明颞区筋膜的多个层次以及血液供应、神经支配情况，明确颞区的颈内外血管与颅脑血管的交通支，剖析注射美容并发症的原因。方法对20具新鲜头部标本进行分组研究，利用铸型、透明、造影和显微解剖等方法，通过计算机叠加处理得到颞区的层次以及血管、神经分束。结果颞区的动脉血供来自颞浅动脉、上颌动脉的分支颞中动脉、颞深前动脉、颞深后动脉，且静脉与动脉相伴随，相互交织成网，并与眼动脉及颅内动脉亦有丰富的吻合支；静脉回流由同名静脉收集于翼丛或下颌后静脉，最终注入上颌静脉；运动神经为穿过颧弓的颞支、颧支。结论颞区的组织层次由浅入深可分为10层，均有血管、神经支配，因此，颞区筋膜可以单层应用，并可形成带感觉神经支配的复合筋膜移植组织，可灵活设计并用于身体各个部位的组织缺损及器官畸形的修复。颞区的血管较丰富，与颈内外、颅内外相互交通，在盲视下操作，需要熟悉解剖，避免失明、脑梗死等严重并发症发生。

Objective To evaluation the layers, bloods vessels and nervous in temporal region, clarify traffic branch of brain vessels and internal and external carotid vessels in the temporal region, analyze the reasons for postoperative complications of cosmetic injections. Methods We divided 20 specimens into 4 groups. The different group uses the different methods of clearing, microdissection, vessel matrix, or radiography, et al. Through the computer added to the layers clearly in this regions. Results Superficial temporal artery, mid- dle temporal artery, deep temporal anterior artery, the deep temporal artery supply the temporal region fascia, and the vein together with the artery. And there are rich anastomosis between temporal artery and ophthalmic artery and intracranial arterial. Venous return by the same name venous collected from the pterygoid venous plexus or mandibular vein, eventually into the maxillary vein. The sensory nerves are temporal branches, zygomatic branches which cross zygomatic arch. Conclusion Organizational level temporal region can be divided into ten layers, have vascular innervations. Temporal fascia can be used in one layer or compound, which include nerve, can be design to repair lots injury of tissues and organ deformities. While, temporal region has lots blood branches communicated with internal carotid, external carotid vessels and cerebral vessels. If injected into the artery and the pressure is too large, the patients will get visual loss, brain embolizations. Operating in blind, we must know anatomic very well before start to inject filler for patients.