Department of Plastic and Aesthetic Surgery, The First Affiliated Hospital/School of Clinical Medicine of Guangdong Pharmaceutical University, Guangzhou, 510080, Guangdong, China.
Department of Cleft Lip and Palate Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing, 100144, China.
Aesthetic Plast Surg. 2020 Feb;44(1):80-86. doi: 10.1007/s00266-019-01495-2. Epub 2019 Sep 18.
This study aimed to introduce a novel approach to study the facial mimetic muscles (FMMs) in relation to the nasolabial fold (NLF) and realize the visualization of complex three-dimensional (3D) structures and spatial relationships of the FMMs.
Nano-computed tomography (nano-CT) and iodine staining techniques were used to obtain the two-dimensional (2D) radiographs of the FMMs. Materialise Mimics software was then used to reconstruct the 3D model of the FMMs.
The zygomaticus major muscle (ZMM) was divided into trunk fibers and branch fibers. The trunk fibers of the ZMM were subdivided into branch fibers layer-by-layer. Adipose tissue in the cheek was not a mass of unorganized fat. It was separated and fixed by branch fibers. Moreover, the trunk fibers of the ZMM were directly connected to the levator anguli oris (LAO), not the skin. On the contrary, the ZMM was connected to the skin by its subdivided branch fibers indirectly. The muscle fibers in the modiolus were organized, rather than disorganized. In other words, the terminal of the trunk fibers of the ZMM was located in the LAO. Moreover, the terminal of the trunk fibers of the LAO was located at the terminal of the trunk fibers of the musculus depressor anguli oris at the corner of the mouth. Furthermore, the levator labii superioris alaeque nasi was not directly connected to the orbicularis oris muscle. It was connected to the combination of the LLS and the rhinaeus.
Although nano-CT has many disadvantages, it enabled the 3D anatomical study of the FMMs in relation to the NLF when combined with iodine staining. We imported the 2D images obtained by nano-CT scanning into the Mimics software, successfully reconstructed the FMMs, and finally obtained images of complex 3D structures of the FMMs. The shapes, positions, and 3D spatial relationships of the FMMs were clearly visualized. The novel insights into the 3D anatomy of the FMMs may help understand the formation of the NLF. Finally, the results of this study may help improve the rejuvenation surgery of the NLF soon.
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
本研究旨在介绍一种研究面中部表情肌（FMMs）与鼻唇沟（NLF）关系的新方法，并实现 FMMs 复杂三维（3D）结构和空间关系的可视化。
采用纳米计算机断层扫描（nano-CT）和碘染色技术获取 FMMs 的二维（2D）射线照片。然后使用 Materialise Mimics 软件重建 FMMs 的 3D 模型。
颧大肌（ZMM）可分为干纤维和分支纤维。ZMM 的干纤维逐层分为分支纤维。颊部脂肪组织不是一团无组织的脂肪。它由分支纤维分隔和固定。此外，ZMM 的干纤维直接与口角提肌（LAO）相连，而不是与皮肤相连。相反，ZMM 是通过其细分的分支纤维间接与皮肤相连。调制器中的肌纤维是有组织的，而不是无组织的。换句话说，ZMM 干纤维的末端位于 LAO 中。此外，LAO 干纤维的末端位于口角降口角肌（musculus depressor anguli oris）干纤维的末端。此外，上唇鼻翼提肌（levator labii superioris alaeque nasi）不是直接与口轮匝肌相连。它与 LLS 和 rhinaeus 的组合相连。
尽管纳米 CT 有许多缺点，但与碘染色结合使用时，它能够对面中部表情肌与鼻唇沟的 3D 解剖学进行研究。我们将通过纳米 CT 扫描获得的 2D 图像导入 Mimics 软件，成功重建了 FMMs，并最终获得了 FMMs 复杂 3D 结构的图像。FMMs 的形状、位置和 3D 空间关系清晰可见。对面中部表情肌 3D 解剖结构的新认识可能有助于理解鼻唇沟的形成。最后，本研究的结果可能有助于改善鼻唇沟的年轻化手术。
证据水平 IV：本杂志要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的完整描述，请参阅目录或在线作者指南 www.springer.com/00266。
