额眉部除皱术的应用解剖学研究

Study of applied anatomy of forehead - brow rhytidectomy

目的:为额眉部除皱术提供解剖学基础。方法:在100个成人颅骨和30具成人尸体标本上解剖和观测了额眉部与除皱术有关的组织结构。结果:眶上和滑车上切迹(孔)至正中线的距离分别为22.8mm±5.3mm和16.5mm±2.8mm,至眶上缘的距离分别为3.5mm±1.4mm和3.2mm±1.5mm。额眉部薄的皮下组织与皮肤和深面的肌组织连接紧密,肌组织与深面的额骨外膜以疏松组织相连,其内走行有眶上、滑车上、颞浅和面血管神经支。眶上动脉神经从眶上缘内、中1/3交界处几近垂直上行,其入肌点是眶上缘上方1.4cm±0.3cm;滑车上动脉神经行于内眦与额正中线之际上1cm点连线的深面,分支入肌点在该线的上2/3部;颞浅动脉额支从鬓角穿出行向额肌,入肌点是外眦上方4.5cm±0.8cm。面神经颞支行于额支动脉的下方,在额肌与眼轮匝肌交角处先交织成网,由网再分支入肌。结论:额眉部除皱术宜于额肌下分离,避免损伤相关的血管神经。

Objective To provide anatomic bases for rhytidectomy on the forehead - brow. Methods The anatomic construction of the forehead-brow related to the rhytidectomy was dissected, observed and measured on the 100 adult skulls and 30 adult cadevers. Results The distance from the supraorbital and supratrochlear netches(or foramia) to midline was 22. 8mm±5. 3mm and 16. 5mm±2. 8mm, and to the supraorbital rim was 3. 5mm±1.4mm and 3. 2mm±1. 5mm. Thin fascia closely linked the skin to the deep muscles, and loose tissue linked muscles to the periosleum on the forehead-brow.The supraorbital, supratrochlear, supertemporal, facial blood vessles and nerves moved between muscle and periosleum. The supraorbital arteris and nerves perpendicularly went up from the intercept of middle1/3and medial1/3 of supraorbital rim. Its point entering muscle(PEM) was 1. 4cm±0. 3cm above supraorbital rim. The supratrochlear arteris and nerves went along commissure line of the 1 cm point above trichion of frontal median and rhanter. Its PEM of branches was superior 2/3 part of the frontal muscule. The frontal branches of supertemporal arteris went from its source to the frontal muscle. Its PEM was 4.5cm±0.8cm above paropia. The temporal branches of facial nerve went under frontal branch of the artery. Its first knited net before entering muscle, and branches of the net distributed to the muscles. Conclusion The dissecting method under the frontal muscule should be put to use to protect related blood vessles and nerves from injury.