Jacono Andrew A, Malone Melanie H
Section Head, Facial Plastic and Reconstructive Surgery, North Shore University Hospital, Manhasset, NY, USA.
Assistant Clinical Professor of Facial Plastic Surgery, New York Eye and Ear Infirmary and Albert Einstein College of Medicine, New York, NY, USA.
Aesthet Surg J. 2017 May 1;37(5):495-501. doi: 10.1093/asj/sjw274.
The cervical retaining ligaments anchor the platysma and soft tissues of the neck to the deep cervical fascia and deeper skeletal structures. The cervical retaining ligaments tether the platysma and prohibit free mobilization and redraping of the platysma muscle in rhytidectomy. This ligament system has previously been described in the literature only qualitatively.
To define the anatomic dimensions of the cervical retaining ligaments and their relation to the platysma muscle in order to better understand the cervical retaining ligament system and how it limits motion of the platysma during rhytidectomy.
Extended deep plane rhytidectomy was performed on 20 fresh cadaveric hemifaces. The extent cervical retaining ligaments were dissected and measured. The anterior extent (width) of the cervical ligament were recorded at three anatomic points on each hemiface: (1) at the level of the inferior border of the mandible; (2) at the top of the thyroid cartilage at the thyroid notch; and (3) at the level of the cricoid.
The average width of the cervical retaining ligaments in the neck was 15.3 mm. The width significantly decreased as they became more inferiorly positioned from the top of the neck at the anatomic measurement points, measuring 17.1 mm, 16.1 mm, and 12.6 mm (P < 0.05).
The cervical retaining ligaments are the support mechanisms of the platysma muscle in the neck. While previously described in only a qualitative manner, this study quantifies the anterior extent of these ligaments and how they invest the lateral platysma muscle. As these ligaments tether the platysma for an average of 1.5 cm, lateral platysma elevation of this distance during rhytidectomy surgery can improve platysmal redraping during rhytidectomy and potentially improve neck rejuvenation.
颈部固定韧带将颈部的颈阔肌和软组织固定于颈深筋膜及更深层的骨骼结构。在除皱术中，颈部固定韧带束缚颈阔肌，阻止颈阔肌自由活动及重新塑形。此前该韧带系统在文献中仅有定性描述。
明确颈部固定韧带的解剖学尺寸及其与颈阔肌的关系，以便更好地理解颈部固定韧带系统及其在除皱术中如何限制颈阔肌的活动。
对20个新鲜尸体半侧面部进行扩大深层平面除皱术。解剖并测量颈部固定韧带的范围。在每个半侧面部的三个解剖点记录颈部韧带的前部范围（宽度）：（1）在下颌骨下缘水平；（2）在甲状软骨甲状切迹顶部；（3）在环状软骨水平。
颈部固定韧带的平均宽度为15.3毫米。在解剖测量点，从颈部顶端向下，其宽度显著减小，分别为17.1毫米、16.1毫米和12.6毫米（P<0.05）。
颈部固定韧带是颈部颈阔肌的支撑结构。虽然此前仅有定性描述，但本研究对这些韧带的前部范围及其如何包裹颈阔肌外侧部分进行了量化。由于这些韧带束缚颈阔肌的平均长度为1.5厘米，除皱手术中颈阔肌外侧抬高这一距离可改善除皱术中颈阔肌的重新塑形，并可能改善颈部年轻化效果。
