Mashkevich Grigoriy, Wang Jeff, Rawnsley Jeffrey, Keller Gregory S
Department of Otolaryngology, Division of Facial Plastic Surgery, New York Eye & Ear Infirmary, New York, New York 10003, USA.
Arch Facial Plast Surg. 2009 Jul-Aug;11(4):240-5. doi: 10.1001/archfacial.2009.47.
To evaluate the submental region of the aging neck with high-frequency ultrasound and to assess the relative contribution of its various components to the appearance of age-related soft-tissue ptosis.
Ten patients with submental soft-tissue excess were recruited from the senior author's (G.S.K.) private practice. The subcutaneous fat compartment, the subplatysmal fat compartment, and the anterior bellies of the digastric muscles were imaged with high-frequency ultrasound and measured in the cephalocaudal dimension. Pseudoherniation of subplatysmal fat, judged in relation to the inferior surface of the digastric muscles, was also assessed from acquired images.
A clear delineation of submental anatomy was obtained with ultrasound in all patients (N = 10, 100%). Hypertrophied digastric muscles (n = 1, 10%) and excessive subplatysmal fat (n = 5, 50%) adversely contributed to the appearance of submental fullness in 6 patients (60%). These findings would not have been predicted with the same degree of accuracy from the physical examination alone.
High-frequency ultrasound provides useful imaging of the submental region and its components. Deeply situated subplatysmal fat and anterior bellies of the digastric muscles, both of which may be difficult to assess on physical examination, can be readily evaluated with ultrasound. When sufficiently enlarged and ptotic, deep tissues of the submental space necessitate an open submentoplasty to restore a youthful neck contour. Preoperative ultrasonography can assist with anatomical imaging of the submental space and help in planning a targeted operative intervention in patients with submental soft-tissue excess.
采用高频超声评估衰老颈部的颏下区域，并评估其各组成部分对与年龄相关的软组织下垂外观的相对贡献。
从资深作者（G.S.K.）的私人诊所招募了10例颏下软组织过多的患者。用高频超声对皮下脂肪层、颈阔肌下脂肪层和二腹肌前腹进行成像，并在头尾方向上进行测量。还从获取的图像中评估颈阔肌下脂肪相对于二腹肌下表面的假性疝出情况。
所有患者（N = 10，100%）均通过超声清晰描绘了颏下解剖结构。1例（10%）二腹肌肥大和5例（50%）颈阔肌下脂肪过多对6例患者（60%）的颏下饱满外观产生了不利影响。仅通过体格检查无法以相同的准确度预测这些结果。
高频超声可为颏下区域及其组成部分提供有用的成像。颈阔肌下深层脂肪和二腹肌前腹在体格检查中可能难以评估，但通过超声可以很容易地进行评估。当颏下间隙的深层组织充分增大和下垂时，需要进行开放性颏下成形术以恢复年轻的颈部轮廓。术前超声检查可辅助颏下间隙的解剖成像，并有助于为颏下软组织过多的患者规划有针对性的手术干预。
