面部浅表肌肉腱膜系统（SMAS）的应用解剖学研究

发布时间：2018-10-08 19:07

【摘要】：目的：进一步深入阐明面部浅表肌肉腱膜系统(superfical musculoaponeuroticsystem，SMAS)的解剖学特点，为临床面部除皱术中施行面部SMAS下广泛剥离时，防止或减少面神经的损伤提供重要形态学基础，为面部除皱术的手术提供解剖学依据。材料与方法： 1．常规福尔马林固定的面部无破损的成人头部标本20侧(男性8侧，女性12侧)和新鲜成人女尸头部标本6侧，逐层剥离皮肤和浅筋膜。剥离浅筋膜后，首先沿下颌骨下缘至下颌角，切断颈阔肌，然后沿耳屏向上入发际(高出眉弓)，逐层切开并向前掀起各层软组织，结合手术显微镜观察面中部组织层次的形态学特点、面神经等结构与组织的层次关系； 2．测量在耳轮上点与外眦上点的连线上和耳屏上切迹点与外眦点的连线上，面神经的额支所经过的相对位置； 3．选择4侧新鲜标本，同一标本面部取4个部位做面部软组织的常规断层切片，结合显微镜下观察面部不同部位软组织的层次特点及其相对应的移行关系。结果： SMAS位于皮下脂肪的深面，是由颈阔肌及其包膜向面部延续而来的，向上延续为颞浅筋膜，经颞浅筋膜与额部的表情肌相连，向前连于颧大肌。SMAS是头面颈部的浅筋膜(即皮下脂肪组织)和深筋膜(包括颈部深筋膜、腮腺咬肌筋膜、颞深筋膜)之间的一个独立的组织层次。面神经的五大分支在腮腺边
[Abstract]:Objective: to further elucidate the anatomical features of the superficial muscle aponeurosis system (superfical musculoaponeuroticsystem,SMAS) in order to perform extensive facial SMAS dissection in clinical facial rhytidectomy. Prevention or reduction of facial nerve injury provides an important morphological basis and provides anatomical basis for facial rhytidectomy. Materials and methods: 1. Routine formalin fixation of the face of 20 adult head specimens without damage (male 8 sides, 12 sides of female) and 6 sides of fresh adult female cadaver head, skin and superficial fascia were removed layer by layer. After peeling off the superficial fascia, first cut off the latissimus cervicalis along the lower margin of the mandible to the angle of the mandible, and then along the ear, upward into the hairline (high above the brow arch), cut the layers of soft tissue layer by layer and lift the soft tissue forward. The morphological characteristics of the middle facial tissue and the relationship between the facial nerve structure and the tissue were observed with the operation microscope. 2. The relative position of the frontal branch of the facial nerve was measured on the line between the superior point of the auricle and the point of the upper lateral canthus and the line between the incisor point and the point of the outer canthus. 3. 4 sides of fresh specimens were selected and 4 parts of the same specimen were taken from the face to make routine sectional sections of the soft tissue of the face. The hierarchical characteristics of soft tissue in different parts of the face and the corresponding transference relationship were observed under microscope. Results: SMAS was located on the deep surface of subcutaneous fat and continued from the latissimus cervicis and its capsule to the face, and upward to the superficial temporal fascia. The superficial temporal fascia is connected to the facial muscles of the frontal part and is connected to the zygomaticus major muscle. SMAS is the superficial fascia (subcutaneous adipose tissue) and the deep fascia (including the cervical deep fascia, the parotid masseter fascia) of the head and neck. A separate layer of tissue between the deep temporal fascia. The five branches of the facial nerve are on the parotid side
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R322

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