Kushima Hideo, Matsuo Kiyoshi, Yuzuriha Shunshuke, Kitazawa Takeshi, Moriizumi Tetsuji
Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan.
Br J Plast Surg. 2005 Jul;58(5):681-7. doi: 10.1016/j.bjps.2005.01.006.
After the surgical correction of aponeurotic blepharoptosis or blepharoplasty, the positions of the eyebrow and hairline change as if the frontal belly is independent from the occipital belly of the occipitofrontalis muscle. Therefore, the occipitofrontalis muscle was studied physiologically with electromyographic evaluation in healthy subjects and anatomically with cadaver dissections. Along with contraction of the levator muscle to maintain an adequate visual field, at a less upward gaze position, contraction of only the frontal belly was induced, and at a more upward gaze position, contraction of both the frontal and the occipital bellies was always induced to lift the eyebrow with the upper eyelid skin. The superficial fascia overlying the occipital belly becomes the temporoparietal fascia and ends at the superior end of the frontal belly, thus creating a superficial musculoaponeurotic system that lifts the eyebrow and pulls the scalp forwards. Beneath the superficial musculoaponeurotic system, the occipital belly of the occipitofrontalis muscle becomes the galea aponeurotica and inserts into the underside of the frontal belly, thus creating a deep musculoaponeurotic system that pulls the superficial musculoaponeurotic system with the scalp backwards. Thus, the occipitofrontalis muscle appears to be composed of two physiologically and anatomically different muscles.
在进行腱膜性上睑下垂手术矫正或眼睑成形术后，眉毛和发际线的位置会发生变化，就好像额腹与枕额肌的枕腹相互独立一样。因此，我们对健康受试者的枕额肌进行了生理层面的肌电图评估研究，并对尸体进行了解剖层面的研究。除了提上睑肌收缩以维持足够的视野外，在向上注视角度较小时，仅诱发额腹收缩；在向上注视角度较大时，则总是诱发额腹和枕腹同时收缩，以抬起眉毛和上睑皮肤。覆盖枕腹的浅筋膜变成颞顶筋膜，并在额腹的上端终止，从而形成一个提起眉毛并向前牵拉头皮的表浅肌肉腱膜系统。在表浅肌肉腱膜系统下方，枕额肌的枕腹变成帽状腱膜，并插入额腹的下面，从而形成一个将表浅肌肉腱膜系统与头皮向后牵拉的深部肌肉腱膜系统。因此，枕额肌似乎由两块在生理和解剖上不同的肌肉组成。
