Dallas, Texas; and Mississauga, Ontario, Canada From the Department of Plastic Surgery, University of Texas Southwestern Medical Center, and The Plastic Surgery Clinic.
Plast Reconstr Surg. 2011 Feb;127(2):835-843. doi: 10.1097/PRS.0b013e318200aa5a.
Experience with anatomical dissection has suggested that two potential complications of rhytidectomy are related to the anatomy of the periauricular adipose compartments: great auricular nerve injury and the "subauricular band" phenomenon. This study describes this anatomy and its relationship to these potential complications.
The results of 24 fresh hemifacial cadaver dissections were included in this study. Injections included the use of methylene blue and fixable dye injected into specific regions around the ear. The study incorporated digital macro photography, time-lapse photography, and three-dimensional cross-sections in multiple planes (coronal, sagittal, and axial planes) to identify structural relationships.
This study defined five periauricular adipose compartments. The main branch of the great auricular nerve always ran within the subauricular membrane. The subauricular membrane was located between the subauricular and inferior adipose compartments. Inadequate dissection of the lateral neck and postauricular area along with failure to release this membrane completely results in banding of the lateral neck, a stigma of face lift surgery. McKinney's point was consistently found to lie where the great auricular nerve travels deep to the inferior border of Lore's fascia and the tail of the parotid. Below this point, the great auricular nerve is closer to the skin surface and more susceptible to potential injury.
Two possible complications of rhytidectomy, great auricular nerve injury and the "subauricular band" phenomenon, are avoidable by understanding the anatomy of the periauricular adipose compartments.
解剖学经验表明，耳周脂肪隔解剖与除皱术的两种潜在并发症有关：耳大神经损伤和“耳下带”现象。本研究描述了这种解剖结构及其与这些潜在并发症的关系。
本研究纳入了 24 例新鲜半面尸体解剖的结果。注射包括将亚甲蓝和可固定染料注入耳周特定区域。该研究结合了数字宏观摄影、延时摄影和多个平面（冠状面、矢状面和轴位）的三维横截面，以确定结构关系。
本研究定义了五个耳周脂肪隔。耳大神经的主要分支始终位于耳下膜内。耳下膜位于耳下和下脂肪隔之间。如果未能充分解剖颈侧和耳后区域，未能完全松解该膜，会导致颈侧带状物形成，这是面部提升手术的一个特征。McKinney 点始终位于耳大神经在 Lore 筋膜下缘和腮腺尾部深面穿行处。在此点以下，耳大神经更接近皮肤表面，更容易受到潜在损伤。
通过了解耳周脂肪隔的解剖结构，可以避免除皱术的两种潜在并发症：耳大神经损伤和“耳下带”现象。
