Jiang Ping, Chen Qiqing, Huang Weifeng
Zhonghua Zheng Xing Wai Ke Za Zhi. 2016 Jul;32(4):280-5.
To determine the safe space for hyaluronic acid(HA) injection through anatomy study of temporal layers.
6 fresh and 8 formaldehyde-fixed cadaver heads were dissected. The skin soft-tissue layers of temporal region were incised through the cranial coronal plane and elevated layer by layer. The morphological features of layers were observed and documented, as well as the relationship of the superficial temporal artery (STA),the temporal branch of facial nerve (TFN) and the middle temporal vein(MTV) with corresponding layers. Relevant neasurements of the superficial temporal fat pad (sTFD) were recorded. With reference of cardever dissection, temporal region injection with HA was carried out clinically to confirm the safety and effect.
In the temporal region, from surface to the temporal fossa, the layers are skin, subcutaneous tissue, superfiacial temporal fascia (STF),loose areolar tissue, superficial layer of deep temporal fascia(sDTF), sTFD, deep layer of deep temporal fascia (dDTF),deep temporal fat pad (dTFD) and temporalis. The temporal skin is tightly attached with the subcutaneous tissue. The STA runs within the subcutaneous tissue on the STF, whereas the TFN within the areolar tissue was just beneath the STF. The loose areolar tissue is a potential layer space. The DTF splits into two sheets of fascia at the line 1 cm above the upper orbital rim to envelope the sTFD, within which the MTV runs backward. The dTFD is the temporal extension of buccal fat pad. With reference of cadever dissection, the target space of temporal HA injection was beneath the temporalis for the area superior to the MTV, whereas within the sTFD for the area inferior to the MTV.67 cases were completed with good result and no complication.
In the upper area of temporal region adjacent to the frontal border, the sub-temporalis space is the safety space for HA injection, while inferior to the middle temporal vein and near the zygoma, the superficial temporal fat pad is the target space for safe HA injection.
通过对颞部层次的解剖学研究，确定透明质酸（HA）注射的安全区域。
解剖6例新鲜尸体头部和8例甲醛固定的尸体头部。通过冠状颅面平面切开颞部的皮肤软组织层，并逐层掀起。观察并记录各层次的形态特征，以及颞浅动脉（STA）、面神经颞支（TFN）和颞中静脉（MTV）与相应层次的关系。记录颞浅脂肪垫（sTFD）的相关测量数据。参照尸体解剖结果，在临床上对颞部进行HA注射，以确认安全性和效果。
在颞部，从表面到颞窝，依次为皮肤、皮下组织、颞浅筋膜（STF）、疏松结缔组织、颞深筋膜浅层（sDTF）、sTFD、颞深筋膜深层（dDTF）、颞深脂肪垫（dTFD）和颞肌。颞部皮肤与皮下组织紧密相连。STA走行于STF上方的皮下组织内，而TFN走行于STF下方的疏松结缔组织内。疏松结缔组织是一个潜在的层次间隙。DTF在上眶缘上方1 cm处分为两层筋膜，包绕sTFD，MTV在其中向后走行。dTFD是颊脂垫的颞部延伸。参照尸体解剖结果，颞部HA注射的目标区域在MTV上方时为颞肌下方，在MTV下方时为sTFD内。67例注射完成，效果良好，无并发症。
在颞部靠近额部边界的上方区域，颞肌下间隙是HA注射的安全区域，而在颞中静脉下方靠近颧骨处，颞浅脂肪垫是HA安全注射的目标区域。
