Accioli de Vasconcellos J J, Britto J A, Henin D, Vacher C
Service de Chirurgie Maxillo-Faciale, Hopital Beaujon, Clichy, France.
Br J Plast Surg. 2003 Oct;56(7):623-9. doi: 10.1016/s0007-1226(03)00310-2.
Many investigators have detailed the soft tissue anatomy of the face. Despite the broad reference base, confusion remains about the consistent nature of the fascial anatomy of the craniofacial soft tissue envelope in relation to the muscular, neurovascular and specialised structures. This confusion is compounded by the lack of consistent terminology. This study presents a coherent account of the fascial planes of the temple and midface. Ten fresh cadaveric facial halves were dissected, in a level-by-level approach, to display the fascial anatomy of the midface and temporal region. The contralateral 10 facial halves were coronally sectioned through the zygomatic arch at a consistent point anterior to the tragus. These sections were histologically prepared to demonstrate the fascial anatomy en-bloc with the skeletal and specialised soft tissues. Three generic subcutaneous fascial layers consistently characterise the face and temporal regions, and remain in continuity across the zygomatic arch. These three layers are the superficial musculo-aponeurotic system (SMAS), the innominate fascia, and the muscular fasciae. The many inconsistent names previously given to these layers reflect their regional specialisation in the temple, zygomatic area, and midface. Appreciation of the consistency of these layers, which are in continuity with the layers of the scalp, greatly facilitates an understanding of applied craniofacial soft tissue anatomy.
许多研究者已详细描述了面部的软组织解剖结构。尽管有广泛的参考依据，但关于颅面软组织包膜的筋膜解剖结构与肌肉、神经血管及特殊结构之间的一致性，仍存在困惑。缺乏统一的术语使这种困惑更加复杂。本研究对颞部和中面部的筋膜平面进行了连贯的阐述。采用逐层解剖的方法，对10个新鲜尸体面部半侧进行解剖，以展示中面部和颞部的筋膜解剖结构。对另外10个对侧面部半侧在耳屏前方的同一位置经颧弓进行冠状切片。对这些切片进行组织学处理，以整体展示筋膜解剖结构与骨骼及特殊软组织的关系。面部和颞部通常有三层皮下筋膜层，且在颧弓处保持连续。这三层分别是表浅肌肉腱膜系统（SMAS）、无名筋膜和肌肉筋膜。此前赋予这些层次的众多不一致名称反映了它们在颞部、颧区和中面部的区域特殊性。认识到这些与头皮层次连续的层次的一致性，极大地有助于理解应用颅面软组织解剖学。
